Medical Claims Officer

3 weeks ago


Dubai, United Arab Emirates Allianz Partners Full time

**Summary**

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

**Main Tasks**
- Evaluates medical claims from the technical and medical perspectives as per policy terms and conditions.
- Checks particular treatment plan is necessary for the patient.
- Refers for a second opinion for cases where there is doubt in treatment plan.
- 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**
- Education: Bachelor’s of Medicine (MBBS)
- Experience: 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**:
36644



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