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Operations Officer

1 month ago

Dubai, United Arab Emirates Allianz Partners Full time

We are Allianz Partners. The leader in assistance and insurance solutions in the areas of international health, assistance, automotive and travel insurance. Allianz Partners is a global family of over 19,000 employees across 78 countries. This role is in the International Health part of the business, which has several well-known customers facing brands such as Allianz Care, Nextcare and Medi24.

The International Health line of business provides international health, life and disability insurance and services, reinsurance, and administration services to a wide range of customers. These include multinational companies, intergovernmental organizations (IGOs), non-governmental organizations (NGOs), private individuals, families, and students. Our mission is to ensure that customers have access to quality healthcare through our support, care, and commitment to go the extra mile. We are a truly global health partner for our customers, ensuring fast and simple access to the best advice, treatment, and value for our customer.

**Summary**

**Main Tasks**
- Manage the assigned tasks related to medical assistance cases.
- Evaluate medical claims according to the guidelines.
- Coordinate with different providers to ensure high quality of service when organizing medical assistance.
- Claims evaluation and processing activities such as checking policy, eligibility, claims creation in the system, follow up upon ongoing claims ensuring the requested turn around time and processing of claims and other tasks related to claims management
- Assist callers on claims process / procedure / network inquiries, explaining policy terms & conditions
- Accommodates Business Units / Travel / TPA International requests with regards to opening international files, placement of Guarantee of Payment, etc.
- Follow the complaints & escalation management process and log in complaints with action & resolution in the system / tools provided by the company
- Ensure proper system related tasks as creating files and Service Providers updates on the portal
- Record tasks in the productivity file, share with management and ensure reaching the level of productivity assigned
- Follow the internal processes and guidelines to ensure reaching the Operational KPIs (Quantity and Quality) and the attendance KPIs
- Request feedback in relation to the performed tasks and discuss with Team Leader the monthly scorecard results
- Monitor daily activities as per the communicated Service Level Agreement, create reports / statistics / analysis and report any deviation
- Attend training sessions as requested and participate in the departmental activities in accordance with the monthly schedule
- Attend internal meetings related to the job as per the internal requirements

**Behavioral Requirements**
- Strong negotiation, communication, attention to detail, time management skills
- Adherence and punctuality, keep an open channel of communication with colleagues inside / outside the team
- Sound knowledge of telephone etiquette
- Ability to work independently and maintain focus under pressure
- Ability to meet tight deadlines
- Ability to work well as part of a team
- to exhibit objectivity and be open-minded towards the ideas and views of others, give as well as welcome feedback, contribute to building team spirit, aid others to succeed
- Ability to comprehend, capture as well as interpret basic customer information, besides upholding the values of the organization
- Ability to follow instructions diligently
- Ability to manage difficult customer situations, to respond promptly to the needs of the customer, solicit feedback to improve service, respond to request for service/assistance
- Ability to adapt to change, meet the changing demands of the work environment, any delays or other unexpected demands
- Ability to treat people with respect under all circumstances, instill trust in others besides upholding the values of the organization
- Dependability in taking responsibility for actions taken
- Flexible to accommodate changes/addition to duties, make efficient use of resources, and availability as per company requirement

**Behavioral Competency**

**Customer & Market Excellence**:

- Strive for excellence at every touch point with the customer
- Foster state-of-art technical/operational knowledge and strive for continuous simplification
- Be the benchmark

**Collaborative Leadership**:

- Empower the team and provide purpose and direction
- Develop people, provide feedback and care to employee wellbeing
- Collaborate and exchange best practice.

**Entrepreneurship**:

- Act on opportunities, anticipate trends, take risk, and promote a culture that allows for honest failure
- Take ownership and responsibility
- Embrace innovation and a culture that allows to make decisions without fear of retribution.

**Trust**:

- Act with integrity, honor commitments, tell the truth
- Foster diversity and inclusiveness
- Act transparently and promote corporate social responsib

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