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Specialist – Claims

Job Responsibilities:

·       Conduct a robust and comprehensive auditing function for all health claims assessed by external claims management companies.

·       Monitor and analyses s of health claims data ensuring alignment with base utilization assumptions and market medical services costs.

·       Compile and prepare regular MIS reports regarding utilization and Medical provider costs and communicate with clients with high L/R

·       Suggest enhancement business procedures ensuring maximum efficiency of processes.

·       Reimbursement process handling from submitting claims until delivering payment with regular reports on TAT and transfer ratio

·       Develop and implement process for detecting Fraud cases.

·       Handling complaints within agreed SLA and reporting them on daily basis

 

Job Qualifications:

·       Medical Degree

·       Post graduate degree is a plus

 

If you are interested in the above mentioned vacancy, please apply now, using the link below, with your resume attached

Note: Please do not change the automatically generated e-mail subject or your application will be discarded.

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  • Allianz is fully committed to a workplace free of discrimination and actively promotes equal opportunities where all candidates have the same opportunity.
  • Allianz is committed to building a diverse workplace and recognizes that diverse employees bring varied skills, knowledge, backgrounds and perspectives to the workplace.