Medical Claims Process -Assistant Manager

at  Allianz Partners

The Assistant Manager is responsible for managing the functions of Medical Services (Inpatient, Outpatient & Retrospective Review) while ensuring that departmental goals, timeline of activities, and compliance measures are met.

• Manage and organize the team ensuring optimum deployment of resources & reporting to the Headquarters
• Devise and implement claims cost control strategies, liaising where necessary with other relevant parts of the business,
• Ensure that all existing operating service standards are consistently met and to devise strategies to improve these still further.
• Devise and obtain approval for manpower and resource plans which ensure continued delivery of agreed service standards as business increases;
• Develop and continually refine objective mechanisms to measure the productivity of individual members of the Department and to devise and implement strategies to increase this productivity.
• Enhance existing claims protocols and review and refine these in the light of experience;
• Continually review the Claims system functionality taking the lead role in identifying required improvements and to liaise as necessary with other relevant parts of the business to achieve these;
• Develop and implement strategies to continually enhance a strong customer focused culture within the Department, liaising with other relevant parts of the business as necessary;
• Ensure continuous learning and development by all department members and to identify training requirements and, in co-operation with other relevant parts of the business, to devise and implement strategies to address these needs;
• Develop and maintain good working relationships with all departments and support them according to their needs;
• Develop and maintain good working relationships with Assistance providers and other external suppliers;
• Develop and implement claims analysis protocols, liaising with other relevant parts of the business as necessary;
• Support actuarial and product development activities;
• Develop and maintain relationship with major clients, intermediaries and with the Company’s own sales and marketing personnel;
• Member of the claims Cost containment
• Responsibility for Health, Safety and Welfare within team (please refer to the Company’s Safety Statement for full list of responsibilities)