Medical Claims Assessor - Dubai, United Arab Emirates - Talent Pal

Description

MAIN TASKS
Evaluates medical claims/invoices from the technical and medical perspectives as per policy terms and conditions.

Apply the claims submission procedure regarding copayment calculation penalty calculation and ensure that submission timeline and process are followed.

Ensures that insurance claims information is entered into the system correctly to ensure accurate processing and timely payment.

Ensures that providers 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 workrelated tasks to be able to facilitate a multitasking 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 stateofart 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:
Bachelors 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

NonExecutive

Allianz Partners

FullTime

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.

We therefore welcome applications regardless of ethnicity or cultural background age gender nationality religion disability or sexual orientation.

Join us. Lets 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:
FullTime


Remote Job:
Not applicable


Employment Type:
Permanent


ID:
39937


Position Cluster:
NonExecutive

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