Claims Management Assessor

1 month ago

dubai, United Arab Emirates Allianz Partners Full time
Claims Management Assessor (DOH Claims) | Allianz Partners DubaiAllianz Partners is a world leader in B2B2C insurance and assistance, offering global solutions that span international health and life, travel insurance, automotive and assistance. Customer driven, our innovative experts are redefining insurance services by delivering future-ready, high-tech high-touch products and solutions that go beyond traditional insurance. Our products are embedded seamlessly into our partners’ businesses or sold directly to customers, and are available through four commercial brands: Allianz Assistance, Allianz Automotive, Allianz Travel and Allianz Care. Present in 75 countries, our 21,100 employees speak 70 languages, handle over 71 million cases each year, and are motivated to go the extra mile to offer peace of mind to our customers around the world.For more information, please visit: Claims Management – Assessor will provide quality service to clients by promptly and effectively assessing and processing claims and approval according to operations set standards for direct type of claims.Claims Management Assessor (DOH Claims) | Allianz Partners Dubai | Apply NowMAIN TASKSEvaluates claims with regards to eligibility and medical necessity if required.Ensures that insurance claims information is entered into the system correctly, to ensure accurate processing and timely payment.Can Perform Direct Claims Documents handling tasks including claims tracking, payment order generation and releasing.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.Compares data on claims applications.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 claims handling work-related tasks (e.g. claims reconciliation review, claim correction, etc.) to be able to facilitate a multi-tasking role.Ensures that high quality standard of work performance is achieved at all times.Filing/MonitoringStands as a reference person for information on inquiries concerning claims processing procedures.Monitors correct application of beneficiary share accordingly on service items billed.Makes sure that claims are properly audited of all data entered with accurate medical claims details.Notes all discrepancies during the course of the system process are properly forwarded and notified to immediate supervisors and concern units.Provide requisition of office supplies for Individual and Team requirement.Other DutiesResearches claims as neededObtains and audit medical records to compute and record patient charges.Performs other related duties incidental to the work described herein.BEHAVIORAL REQUIREMENTSAttention to detail and ability of multi-task.Organizational & time management skills.Excellent team player.Ability to meet tight deadlines.Ability to work under pressure to tight deadlines.Strong communication skills.Ability to work well with all levels of internal management and staff, as well as outside clients and users.Ability to demonstrate sounds work ethics.Show Flexibility With Excellent Interpersonal Skills.Flexible to work in shifting schedule.Demonstrate commitment to produce output base results.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.Must have the ability to communicate sensitively and effectively with claims department and other departments having regards for the strict need for confidentiality.BEHAVIORAL COMPETENCYCustomer & Market Excellence:Strive for excellence at every touch point with the customerFoster state-of-art technical/operational knowledge and strive for continuous simplificationBe the benchmarkCollaborative Leadership:Empower the team and provide purpose and directionDevelop people, provide feedback and care to employee wellbeingCollaborate and exchange best practice.Entrepreneurship:Act on opportunities, anticipate trends, take risk, and promote a culture that allows for honest failureTake ownership and responsibilityEmbrace innovation and a culture that allows to make decisions without fear of retribution.Trust:Act with integrity, honor commitments, tell the truthFoster diversity and inclusivenessAct transparently and promote corporate social responsibility.MINIMUM REQUIREMENTSBachelor’s degree ( Nursing ), with at least 2 years of clinical experience background preferred.3+ years filing/documentation experience. Experience within the Health Care Industry, TPA’s, insurance companies, Hospitals, Medical Centers is a plus.Physically fit to carry out duties .MINIMUM REQUIREMENTSBachelor’s degree ( Nursing ), with at least 2 years of clinical experience background preferred.3+ years filing/documentation experience. Experience within the Health Care Industry, TPA’s, insurance companies, Hospitals, Medical Centers is a plus.Physically fit to carry out duties.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.41371 | Operations | Professional | Non-Executive | Allianz Partners | Full-Time | PermanentAllianz 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.We therefore welcome applications regardless of ethnicity or cultural background, age, gender, nationality, religion, disability, or sexual orientation.Don’t miss out on this exciting opportunity – apply now at dubaiofferz.com
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