Summary

The Medical Claims - Assessor will provide quality service to clients by promptly and effectively assessing and processing claims and approval according to operations set standards.

Main Tasks

• Manages routine daily claims administration work.

• Coordinates work flow & meet deadlines.

• Evaluates claims with regards to eligibility.

• International Preauthorization.

• Attends calls and e-mails from insurance companies, clients, and providers.

• Makes suggestions to improve service.

• Increases efficiency, minimizes errors, and administration time.

• Coordinates with different departments within the company.

• Reports errors when detected.

Behavioral Requirements

• Strong verbal and written communication skills. Must have the ability to communicate sensitively and effectively with claims department and other departments having regards for the strict need for confidentiality.

• Show flexibility, excellent interpersonal skills.

• Team Player.

• 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.

• 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.

• To be capable of responding diplomatically to pressures and problems showing a calm approach to working towards deadlines and always able to show an innovative and creative approach to work.

• Ability to work well with all levels of internal management and staff, as well as outside clients and users.

• Flexible and ability to work shift .

Behavioral Competency

Customer & Market Excellence:

• Strive for excellence at every touch point with the customer

• Foster state-of-art 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 inclusiveness Act transparently and promote corporate social responsibility.

Minimum Requirements

• Bachelor\'s degree (Nursing): with at least 2 years of clinical experience.

• 3+ years claims processing experience in an Insurance / TPA environment.

• 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.

Allianz