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Medical Claims Senior Officer

2 months ago

Dubai, Dubai, United Arab Emirates Allianz Partners Full time

Job Summary

We are seeking a highly skilled Medical Claims Senior Officer to join our team at Allianz Partners. As a key member of our claims management team, you will be responsible for managing routine daily claims administration work, coordinating workflow, and meeting deadlines.

Key Responsibilities

  • Claims Administration: Manage routine daily claims administration work, ensuring timely and accurate processing of claims.
  • Workflow Coordination: Coordinate workflow with internal teams and external stakeholders to ensure seamless claims processing.
  • Claims Evaluation: Evaluate claims for eligibility, ensuring compliance with company policies and procedures.
  • Decision Making: Make decisions on high-cost and complicated cases based on standard operating procedures.
  • International Preauthorization: Handle international preauthorization cases as required, ensuring compliance with regulatory requirements.
  • Communication: Attend calls and emails from insurance companies, clients, and providers, responding to queries and resolving issues.
  • International Coordination: Coordinate with international providers for direct billing, ensuring timely and accurate payment.
  • Process Improvement: Identify opportunities for process improvement, suggesting changes to increase efficiency and minimize errors.

Requirements

  • Organizational Skills: Possess strong organizational and time management skills, with the ability to prioritize tasks and meet deadlines.
  • Teamwork: Demonstrate excellent teamwork and communication skills, with the ability to work effectively with internal teams and external stakeholders.
  • Work Ethics: Demonstrate sound work ethics, with a strong commitment to confidentiality and integrity.
  • Flexibility: Show flexibility and adaptability, with the ability to respond to changing priorities and deadlines.
  • Interpersonal Skills: Possess excellent interpersonal skills, with the ability to communicate effectively with claims department and other departments.
  • Problem Solving: Demonstrate the ability to respond diplomatically to pressures and problems, showing a calm approach to working towards deadlines.
  • Initiative: Exercise initiative and take ownership of tasks, with the ability to work independently and as part of a team.