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The role of Claims Officer involves processing medical claims for clients in their assigned region. We ensure a high level of client service while processing claims within an industry leading 48 hours. The Claims Officer will process Medical Providers’ Claims, making sure that services are eligible as per policy terms and conditions, are in correlation with the authorized guarantee of payment given and are paid as per the agreed tariffs with providers. The Claims Department is an extremely fast paced environment, with many different languages used and a mixture of cultures.
Job Responsibility:
Examine and process Claims within the agreed company SLA to guarantee customer satisfaction and retention
Use Allianz Partners client database accurately and effectively to ensure reports generated give a true reflection of the department’s workload, which consequently facilitates effective target planning
Contribute to the team and departmental productivity targets so that the agreed SLA is achieved
In line with the company’s policy on cost containment identify duplicate payments, overbilling, up coding, possible non-disclosure and fraudulent claims
Respond to customer enquiries accurately and professionally and if necessary, liaise with other departments for support to ensure an efficient and professional response is given thereby achieving customer satisfaction
Requirements:
1-2 years experience in a Medical Claims role is required
Strong Knowledge of Microsoft Office (Excel, Word)
A highly customer-focused individual with strong interpersonal, communicative and accuracy skills
Team player
Ability to demonstrate sounds work ethics
Can work with minimal supervision and comfortable working with deadlines
Must be willing to work onsite in Makati first 6 months
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