Description:

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

Senior Medical Claims officer is also responsible for team success by agreeing, implementing and monitoring individual and team objectives and targets ensuring company policies and procedures are adhered to.

Key responsibilities/What you do:

Assesses approval of medical approvals as well as policy use.
Channels Medical Claims officers in handling difficult medical cases and optimize the quality and quantity output.
Monitors daily output on the number of case done and decrease in number of errors committed.
Provides second opinion for cases where there is doubt in treatment plan.
Decides approvals as per policy conditions.
Assess high-cost claims and provide decision on high cost and complicated cases.
Provides clear feedback on queries from call Centre team.
Provides clients an understanding of any declined medical claims.
Ability to leverage AI for optimizing workflow and reducing errors in claims management.
Manages routine daily claims administration work.
Coordinates workflow & meet deadlines.
Provides on job training to team members, as necessary.

Key requirements/What you bring:

Bachelors of Phramacy.
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

Key benefits/What we offer:

Our employees play an integral part in our success as a business. We appreciate that each of our employees are unique and have unique needs, ambitions and we enjoy being a part of their journey.

We are there to empower and encourage you with your personal and professional development ensuring that you take control by offering a large variety of courses and targeted development programs. All that in a global environment where international mobility and career progression are encouraged. Caring for your health and wellbeing is key priority for us. This is why we build Work Well programs to providing you with peace of mind and give the flexibility in planning and arranging for a better work-life balance.

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.
We therefore welcome applications regardless of ethnicity or cultural background, age, gender, nationality, religion, disability, or sexual orientation. 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 functions, Allianz entities and geographies. Therefore, the company encourages its employees to be motivated in gaining varied skills from different positions and to collect experiences from across Allianz Group

2 Jobs im Bereich Treatment Plan Evaluation in Ägypten

Precertification Officer

Senior Medical Claims Officer