Medical Claims Assessor
5 months ago
**Summary**
The Medical Claims - Assessor will provide quality service to clients by promptly and effectively assessing and processing claims and approval according to operations set standards.
**Main Tasks**
- Manages routine daily claims administration work.
- Coordinates work flow & meet deadlines.
- Evaluates claims with regards to eligibility.
- International Preauthorization.
- Makes suggestions to improve service.
- Increases efficiency, minimizes errors, and administration time.
- Coordinates with different departments within the company.
- Reports errors when detected.
**Behavioral Requirements**
- Strong verbal and written communication skills. Must have the ability to communicate sensitively and effectively with claims department and other departments having regards for the strict need for confidentiality.
- Show flexibility, excellent interpersonal skills.
- Team Player.
- Knowledge of overall insurance industry practices is a plus; the ability to exercise initiatives and be able to work flexibly under pressure and to tight deadlines.
- 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.
- To be capable of responding diplomatically to pressures and problems showing a calm approach to working towards deadlines and always able to show an innovative and creative approach to work.
- Ability to work well with all levels of internal management and staff, as well as outside clients and users.
- Flexible and ability to work shift.
**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 degree (Nursing): with at least 2 years of clinical experience.
- 3+ years claims processing experience in an Insurance / TPA environment, A Must to have coding Expierence.
- 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**:
100% on-site
**Employment Type**:
Permanent
**ID**:
44264
**Position Cluster**:
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