Reimbursement Assessor

**Summary**

Reimbursment Claims officer provides quality service to clients, promptly and effectively assesses and process claims and approval according to operations set standards. 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.

**Main Tasks**
- Evaluates medical claims from the technical and medical perspectives as per policy terms and conditions.
- Channels claims officers in handling difficult medical cases and optimize the quality and quantity output.
- Checks particular treatment plan is necessary for the patient.
- Refers for a second opinion for cases where there is doubt in treatment plan.
- Provides clients an understanding of any declined medical claims.
- Maintains daily productivity targets and service levels.
- Manages routine daily claims administration work.
- Coordinates work flow & meet deadlines.

**Behavioral Requirements**
- 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 claims department and other departments having regard for the strict need for confidentiality.
- Experience of working with senior managers and understanding the necessity to act in a pleasant and courteous manner and to be able to work effectively with others.
- The ability to exercise initiatives and be able to work flexibly under pressure and to tight deadlines

**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 responsibility.

**Minimum Requirements**
- Bachelor’s of Medicine ( MBBS ) or Pharmacy.
- 2+ years Medical Practical Experience (reputable insurance provider, broker or a TPA experience a plus).
- Physically fit to carry out duties.
- Legally permitted to work in the country of operations.
- Fluency in MS Office (Excel, Word, Outlook, PowerPoint) and general internet navigation and research skills

**Job Level**:
Professional

**Location**:

- Dubai, AE**Area of Expertise**:
Operations

**Unit**:
Allianz Partners

**Employing Entity**:
NEXTCARE Claims Management LLC

**Job Type**:
Full-Time

**Remote Job**:
Hybrid working

**Employment Type**:
Permanent

**ID**:
36843