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Senior Medical Claims Officer - Physicians at Allianz Global Corporate & Specialty SE
Cairo, Cairo, Egypt -
Full Time

Start Date

Immediate

Expiry Date

28 Dec, 25

Salary

0.0

Posted On

29 Sep, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

No

Skills

Medical Claims, Claims Processing, Team Management, Policy Assessment, Client Communication, AI Optimization, Training, High-Cost Claims, Error Reduction, Workflow Coordination, Medical Approvals, Feedback Provision, Case Assessment, Daily Administration, Problem Solving, MS Office

Industry

Financial Services

Description
Description: Senior Medical Claims officer provides quality service to clients, promptly and effectively assesses and process claims and approval according to operations set standards. Senior Medical Claims officer 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 responsibilities/What you do: Assesses approval of medical approvals as well as policy use. Channels Medical Claims officers in handling difficult medical cases and optimize the quality and quantity output. Monitors daily output on the number of case done and decrease in number of errors committed. Provides second opinion for cases where there is doubt in treatment plan. Decides approvals as per policy conditions. Assess high-cost claims and provide decision on high cost and complicated cases. Provides clear feedback on queries from call Centre team. Provides clients an understanding of any declined medical claims. Ability to leverage AI for optimizing workflow and reducing errors in claims management. Manages routine daily claims administration work. Coordinates workflow & meet deadlines. Provides on job training to team members, as necessary. Key requirements/What you bring: Bachelors of Medicine. 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
Responsibilities
The Senior Medical Claims Officer assesses and processes medical claims while ensuring adherence to company policies. They also provide guidance to team members and monitor performance to optimize output and reduce errors.