Claims Retrospective Associate

Job description

Job Overview : The Claims Retrospective Associate will provide quality service to clients, promptly and effectively assesses and process IP and or OP claims according to operations set standards. 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. • 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. • Manages routine daily claims administration work. • Coordinates work flow & meet deadlines. • Provides on job training to team members as necessary. AI READINESS Work effectively in an environment shaped by artificialintelligence (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 of Pharmacy / Dentistry / Medicine. •Medical Practical Experience (reputable insurance provider, broker or a TPA experience a plus) OR Entry Level •Physically fit to carry out duties. •Certified Medical Coder [Preferable] •Legally permitted to work in the country of operations. •Fluency in MS Office (Excel, Word, Outlook, PowerPoint) and general internet navigation and research skills 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.