Job Description
- Review of complex and high cost claims to determine financial and risk accuracy and in-depth review of written dispute requests received from providers of denied or incorrect payments based on contractual arrangements with providers and non-contractual providers.
- Offer assistance to junior staff on challenging cases.
- Identify trends and areas for improvement in the claims process.
- Retrospective auditing of paid claims. This includes flagging of overpaid claims for recovery.
- Prepare concise documentation and audit reports, including recommendations to claims management for improvements with corrective action plans;
- Mentor and coach new and existing staff on best practices and company policies.
- Ensure claims handling complies with company policies, industry regulations, and legal requirements.
- Other Ad hoc duties as required.
AI READINESS Work effectively in an environment shaped by artificial intelligence (AI), machine learning, data analytics and cloud-based tools, using insights responsibly with our standards of data governance, security and ethical use
Key Requirements/What You Bring
- Bachelor’s degree in any Medical field, Paramedical, Finance, Business Administration, Insurance, or a related field preferred.
- Minimum 5 years’ experience in a customer focused environment, ideally in clinical, paramedical roles or TPA or insurance roles.
- Demonstrated understanding of medical claims processes and procedures, and ability to recognize and interpret variances
- Proficiency in MS Office and general internet navigation and research skills
- Must be detail oriented and have the ability to work independently
- Legally permitted to work in the country of operations.
- Hybrid working option available as per business requirements.
How we hire Allianz Partners does not accept unsolicited CV’s or approaches from agencies. We only work with partners on our approved supplier list, under contract. Any unsolicited submission will not be considered.
Key Benefits/What We Offer
Allianz Partners is a world leader in B2B2C insurance and assistance, offering global solutions that span international health and life, travel insurance, automotive and assistance. Customer driven, our innovative experts are redefining insurance services by delivering future-ready, high-tech high-touch products and solutions that go beyond traditional insurance.
Our products are embedded seamlessly into our partners’ businesses or sold directly to customers and are available through four commercial brands: Allianz Assistance, Allianz Automotive, Allianz Travel and Allianz Care. Present in 75 countries, our 21,100 employees speak 70 languages, handle over 71 million cases each year, and are motivated to go the extra mile to offer peace of mind to our customers around the world.
We at Allianz believe in a strong inclusive culture that encourages people to speak their minds, get involved and question the status quo. We are proud to be an equal opportunity employer and 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 race, ethnicity or cultural background, age, gender, nationality, religion, social class, disability, sexual orientation, or any other characteristics protected under applicable local laws and regulations.
At Allianz Partners, AI is revolutionizing customer service and claims management through innovative solutions. These AI-driven tools enhance productivity by streamlining complex claims processes, reducing administrative burdens, and accelerating resolution times. Our AI-powered technology has made claims processing faster, offering quicker resolutions. All while ensuring human oversight for claims to maintain service integrity. By embracing AI and Emerging Technologies, Allianz Partners continues to lead the industry, meeting ever-changing customer needs with innovative solutions. Our commitment to Ethical AI practices safeguards data integrity and trust, ensuring responsible deployment across all operations. This approach not only enhances customer experiences but also supports strategic initiatives like fraud detection and personalized product offerings, solidifying Allianz Partners’ position as a leader in the insurance sector.
Great to have you on board. Let’s care for tomorrow.