Medical claims Officer - Pharmacist only

Over view:
Medical Claims officer provides quality service to clients, promptly and effectively assesses and process claims and approval according to operations set standards.
Senior Medical Claims officer is also responsible for team success by agreeing, implementing and monitoring individual and team
objectives and targets ensuring company policies and procedures are adhered to.

 What you do 

• Assesses approval of medical approvals as well as policy use.
• Channels Medical Claims officers in handling difficult medical cases and optimize the quality and quantity output.
• Attention to detail and quality, with the ability to use AI analytics to ensure accuracy and consistency in work. 
• Provides second opinion for cases where there is doubt in treatment plan.
• Assess high cost claims and provide decision on high cost and complicated case, Communicate sensitively and effectively with the Precertification department and other departments, maintaining confidentiality and using AI tools to support communication 
• Provides clear feedback on queries from call Centre team.
• Provides clients an understanding of any declined medical claims

• Manages routine daily claims administration work.
• Coordinates work flow & meet deadlines.
• Provides on job training to team members as necessary.

What you bring

Key requirments

Bahelor’s of Pharmacy 

Medical Practical Experience (reputable insurance provider, broker or a TPA experience a plus) OR Entry Level

• Strong verbal and written communication skills

• Show flexibility, excellent interpersonal skills.

• Team Player.
• Attention to detail and quality.
• Ability to work well with all levels of internal management and staff, as well as outside clients and users.
• Ability to train other staff.
• The ability to communicate sensitively and effectively with Precertification department and other departments having regard for the
strict need for confidentiality.
• Show flexibility and excellent interpersonal skills, using AI insights to foster collaboration and teamwork. 
• The ability to exercise initiatives and be able to work flexibly under pressure and to tight deadlines.

Our employees play an integral part in our success as a business. We appreciate that each of our employees is unique and has unique needs and ambitions, and we enjoy being a part of their journey.

We are there to empower and encourage you with your personal and professional development ensuring that you take control by offering a large variety of courses and targeted development programs. All that in a global environment where international mobility and career progression are encouraged. Caring for your health and wellbeing is a key priority for us. This is why we build Work Well programs to providing you with peace of mind and give the flexibility in planning and arranging for a better work-life balance

Allianz Group is one of the most trusted insurance and asset   management companies in the world. Caring for our employees, their ambitions,   dreams and challenges, is what makes us a unique employer. Together we can   build an environment where everyone feels empowered and has the confidence to   explore, to grow and to shape a better future for our customers and the world   around us.

At Allianz, we stand for unity: we believe that a united world is a   more prosperous world, and we are dedicated to consistently advocating for   equal opportunities for all. And the foundation for this is our inclusive   workplace, where people and performance both matter, and nurtures a culture   grounded in integrity, fairness, inclusion and trust.

We therefore welcome applications regardless of ethnicity or cultural   background, age, gender, nationality, religion, social class, disability or   sexual orientation, or any other characteristics protected under applicable   local laws and regulations.

Great to have you on board. Let's care for tomorrow.