Job Details

The role of Senior Claims Officer involves processing medical claims for clients worldwide while supporting your Team and Manager to deliver on Department KPI\'s. We ensure a high level of client service while processing claims within an industry leading 48 hours. The Claims Department is a very fast paced and challenging environment, with many different languages used and a mixture of cultures.

Key Responsibilities

• Process claims within the agreed company SLA, Clear to Zero, and adjudicate each claim in accordance with AWC policy benefits to achieve company loss ratio targets
• Ensure accurate and efficient adjudication of each claim, to deliver a superior client experience and accurate reporting
• Consistently contribute to departmental success by meeting agreed Individual and team targets for both productivity and quality
• Investigate and identify possible duplicate payments, non-disclosure and fraudulent claims in line with company cost containment policy
• Foster healthy inter-departmental relationships by responding to internal customer queries in a professional, solution focused manner to ensure an efficient response is provided
• Assume additional administrative tasks to effectively support the Team Leader
• Manage and resolves escalations from Members, Brokers, CRM, HL and other department as required
• Distribute the claims for processing , assuring that the claims are processed within the agreed TAT and the records are updated accordingly
• Assist the Claims officers in the review of complicated Medical cases
• Contribute in the Claims data analysis and to come up with solutions to the daily challenges of the Department
• Handles Finance related issues encountered in Claims processing
• Support the releasing function, as operationally necessary
• Give support and guidance on escalated issues, complaints and challenging claims and lead the Claims officers by example .
• Assist in the onboarding of new team members to the team to ensure team targets are achieved

Key Requirements

• Experience working in a Claims Officer role
• Strong Knowledge of Microsoft Office ( Excel, Word)
• Experience in mentoring
• Experience in Claims Department
• Customer focused
• Strong communication (verbal & written)
• Ability to work effectively within a team environment
• Honesty and Integrity
• Ability to work under pressure
• Ability to prioritise workload and manage time effectively
• Highly motivated and proactive
• Ability to motivate others

As an equal opportunity employer, Allianz Partners recognizes that our strength lies in our people and we are committed to diversity and inclusivity. So if you would like to be part of a global company that offers international career opportunities, kick-start your career and dare to join us!

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Allianz