Reimbursement Claims Assessor

at  Allianz Partners

Reimbursement Claims Assessor provides quality service to clients, promptly and effectively assesses and process claims and approval according to operations set standards.
Reimbursement Claims Assessor is also responsible for team success by agreeing, implementing and monitoring individual and team objectives and targets ensuring company policies and procedures are adhered to.

KEY REQUIREMENTS/WHAT YOU BRING:

• Bachelor’s of Medicine ( MBBS ) or Pharmacy.
• 2+ years Medical Practical Experience (reputable insurance provider, broker or a TPA experience a plus).
• 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

• Evaluates medical claims from the technical and medical perspectives as per policy terms and conditions.
• Channels claims officers in handling difficult medical cases and optimize the quality and quantity output.
• Checks particular treatment plan is necessary for the patient.
• Refers for a second opinion for cases where there is doubt in treatment plan.
• Provides clients an understanding of any declined medical claims.
• Maintains daily productivity targets and service levels.
• Manages routine daily claims administration work.
• Coordinates work flow & meet deadlines.