Claims Management Processing Officer [Egypt]


 

We are Allianz Partners. The leader in assistance and insurance solutions in the areas of international health, assistance, automotive and travel insurance. Allianz Partners is a global family of over 19,000 employees across 78 countries. This role is in the International Health part of the business, which has a number of well-known customer facing brands such as Allianz Care, Nextcare and Medi24.
The International Health line of business provides international health, life and disability insurance and services, reinsurance and administration services to a wide range of customers. These include multinational companies, intergovernmental organizations (IGOs), non-governmental organizations (NGOs), private individuals, families and students. Our mission is to ensure that customers have access to quality healthcare through our support, care and commitment to go the extra mile. We are a truly global health partner for our customers, ensuring fast and simple access to the best advice, treatment and value for our customer.
Main Tasks:
  • Ensures that insurance claims information is entered into the system correctly, to ensure accurate processing and timely payment.
  • Ensures that provider’s 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.
  • Compares data on claims applications.
  • Screens claim documents and process claim adjustment.
  • Ensures Payment Orders are properly created and forwarded accordingly for final releasing, documentation and filing.
  • Ensures adaptability in various work-related tasks to be able to facilitate a multi-tasking role.
  • Ensures that high quality standard of work performance is achieved at all times.

Filing/Monitoring
  • Stands as a reference person for information on inquiries concerning claims processing procedures.
  • Monitors correct application of beneficiary share accordingly on service items billed.
  • Makes sure that claims are properly technically audited of all data entered with accurate medical claims details.
  • Notes all discrepancies during the course of the system process are properly forwards and notifies to immediate supervisors.

Other Duties
  • Researches claims as needed
  • Performs other related duties incidental to the work described herein.
  • Minimum Requirments :
  • Bachelor’s Degree; (Science) Paramedical background preferred.
  • 2+ year’s filing/documentation experience. Experience within the Health Care Industry, TPA’s, insurance companies, Hospitals, Medical Centers is 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 skills.

Job Level:
Entry Level
Location:
EG
Available until:
09/06/2023
Area of Expertise:
Operations
Unit:
Allianz Partners
Employing Entity:
Nextcare Egypt
Job Type:
Full-Time
Remote Job:
Not applicable
Employment Type:
Permanent
ID:
26790


 

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