Medical claims Officer - Pharmacist only at Allianz Global Corporate & Specialty SE

Cairo, Cairo, Egypt -

Full Time

Start Date

Immediate

Expiry Date

16 Jan, 26

Salary

0.0

Posted On

18 Oct, 25

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Pharmacy, Medical Claims, Communication Skills, Attention to Detail, Team Collaboration, AI Analytics, Training, Client Interaction, Confidentiality, Problem Solving, Workflow Coordination, Feedback, Medical Approvals, Policy Applications, Interpersonal Skills, Initiative

Industry

Financial Services

Description

A Medical Claims Officer delivers high-quality service to clients by promptly and accurately assessing, processing, and approving claims in line with operational standards. A Senior Medical Claims Officer also drives team success by setting, implementing, and monitoring individual and group objectives, ensuring strict compliance with company policies and procedures. Key responsibilities/What you do: Evaluate medical approvals and policy applications. Guide Medical Claims Officers in managing complex medical cases, enhancing both quality and productivity. Maintain meticulous attention to detail and quality, leveraging AI analytics to ensure consistency and precision. Offer second opinions on cases with uncertain treatment plans. Review high-cost claims, make informed decisions on complicated cases, and communicate sensitively with the Precertification and other departments, upholding confidentiality while using AI tools to support communication. Provide clear, constructive feedback to the Call Centre team. Explain declined medical claims to clients with clarity. Handle routine daily claims administration efficiently. Coordinate workflow to meet deadlines. Deliver on-the-job training to team members as needed Key requirements/What you bring: Bachelor’s degree in Pharmacy. Practical medical experience with a reputable insurance provider, broker, or TPA is advantageous; entry-level candidates are also considered. Strong verbal and written communication skills. Flexibility and excellent interpersonal abilities. A collaborative team player. Keen attention to detail and commitment to quality. Ability to work effectively with all levels of internal management, staff, and external clients. Competence in training other staff members. Skilled in communicating sensitively and effectively with the Precertification and other departments, respecting strict confidentiality requirements. Use AI insights to enhance collaboration and teamwork. Initiative-driven, able to work flexibly under pressure and meet tight deadlines. Key benefits/What we offer: Our employees play an integral part in our success as a business. We appreciate that each of our employees are unique and have unique needs, 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 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 shape a better future for our customers. We at Allianz believe in a diverse and inclusive workforce and are proud to be an equal opportunity employer. We encourage you to bring your whole self to work, no matter where you are from, what you look like, who you love or what you believe in. We therefore welcome applications regardless of ethnicity or cultural background, age, gender, nationality, religion, disability, or sexual orientation. Join us. Let's care for tomorrow. Note: Diversity of minds is an integral part of Allianz' company culture. One means to achieve diverse teams is a regular rotation of Allianz Executive employees across functions, Allianz entities and geographies. Therefore, the company encourages its employees to be motivated in gaining varied skills from different positions and to collect experiences from across Allianz Group

Responsibilities

The Medical Claims Officer evaluates medical approvals and policy applications while guiding team members in managing complex cases. They maintain quality and detail in claims processing and communicate effectively with various departments.