Medical Claims Officer- physician only

Medical Claims Officer- physician only

Overview

• Claims Pre-certification and Adjudication with compliance to established Policy Guidelines as well as managing & providing overall guidance about Medical Cases review & authorization over Phone.
• Responding to queries regarding cover, claims, hospitalization, complaints
• Commit to the department`s service standards across phone, email, live chat, and customer experience metrics such as customer satisfaction and NPS.
• Multi-tasking of daily assigned workload as well as ad hoc assignments and follow up on individual cases.
• Develop extensive and sound product knowledge to provide timely and accurate information to our clients.
• Responsible for providing outstanding customer service to clients and ensuring customer satisfaction and retention.

Key Responsibilities/ what you do

• Manages routine daily claims administration work.
• Coordinates work flow & meet deadlines.
• Evaluates claims with regards to eligibility.
• Takes decisions on high cost and complicated cases based on standard operating procedures.
• Handles International Preauthorization cases as required.
• Attends calls and e-mails from insurance companies, clients, and providers.
• Coordinates with international providers for direct billing.
• Makes suggestions to improve service.
• Increases efficiency, minimizes errors and administration time.
• Analyze data using AI to identify areas for service improvement, increase efficiency, minimize errors, and reduce administration time.

Minimum Requirements/ What you bring

• Bachelor’s of Medicine (MBBS)
• Medical 1 year Practical Experience in UAE claims, DRG claims and coding skills (reputable insurance provider, broker or a TPA experience a plus).
• Legally permitted to work in the country of operations.
• Fluency in MS Office (Excel, Word, Outlook, PowerPoint) and general internet navigation and research skill
• Technical Skills: Proficiency in MS Office applications and experience with AI software and tools. Skills in data analysis, machine learning, and AI-driven research are highly desirable.

What we offer

Our employees play an integral part in our success as a business. We appreciate that each of our employees is unique and has unique needs and 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 a 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 to shape a better future for our customers and the world around us.

At Allianz, we stand for unity: we believe that a united world is a more prosperous world, and we are dedicated to consistently advocating for equal opportunities for all. And the foundation for this is our inclusive workplace, where people and performance both matter, and nurtures a culture grounded in integrity, fairness, inclusion and trust.

We therefore welcome applications regardless of ethnicity or cultural background, age, gender, nationality, religion, social class, disability or sexual orientation, or any other characteristics protected under applicable local laws and regulations.

Join us. Let's care for tomorrow.