Medical Claims Assessor
2 months ago
**MAIN TASKS**
Evaluates medical claims/invoices from the technical and medical perspectives as per policy terms and conditions.
Ensures that insurance claims information is entered into the system correctly, to ensure accurate processing and timely payment.
Ensures that provider’s fees and service items charges coincide with their existing contract price list with Nextcare.
Ensures the accuracy of the entered data as per the existing standard steps and procedures of direct claims processing.
Screens claim documents and process claim adjustment.
Ensures Payment Orders are properly created and forwarded accordingly for final documentation and filing.
Ensures adaptability in various work-related tasks to be able to facilitate a multi-tasking role.
Ensures that high quality standard of work performance is achieved at all times.
Maintains daily productivity targets and service levels.
**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 REQUIREMENTS**:
**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 inclusivenes
- 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.
- Certified Medical Code
- Legally permitted to work in the country of operations.
- Fluency in MS Office (Excel, Word, Outlook, PowerPoint) and general internet navigation and research skills
39937 | Customer Services & Claims | Professional | Non-Executive | Allianz Partners | Full-Time | Permanent
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 shape a better future for our customers.
We at Allianz believe in a diverse and inclusive workforce and are proud to be an equal opportunity employer. We encourage you to bring your whole self to work, no matter where you are from, what you look like, who you love or what you believe in.
Join us. Let's care for tomorrow.
Note: Diversity of minds is an integral part of Allianz' company culture. One means to achieve diverse teams is a regular rotation of Allianz Executive employees across functi
**Job Level**:
Professional
**Location**:
- Dubai, AE**Area of Expertise**:
Customer Services & Claims
**Unit**:
Allianz Partners
**Employing Entity**:
NEXTCARE Claims Management LLC
**Job Type**:
Full-Time
**Remote Job**:
Not applicable
**Employment Type**:
Permanent
**ID**:
39937
**Position Cluster**:
Non-Executive
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