Înapoi la căutare: Medical claims / România

Medical claims Officer - Pharmacist only

România
Allianz

Publicat pewww.allianz.co.uk 06 Apr 2025

Summary: 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 responsbilities/ What to 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.   Behavioral Requirements/ what to bring • Strong verbal and written communication skills. • Show flexibility, excellent interpersonal skills. • Team Player. • Attention to detail and quality. • Ability to work well with all levels of internal management and staff, as well as outside clients and users. • Ability to train other staff. • The ability to communicate sensitively and effectively with Precertification department and other departments having regard for the strict need for confidentiality. • Experience of working with senior managers and understanding the necessity to act in a pleasant and courteous manner and to be able to work effectively with others. • The ability to exercise initiatives and be able to work flexibly under pressure and to tight deadlines.   Key Requirments/ what to bring Bachelor’s of Pharmacy  Medical Practical Experience (reputable insurance provider, broker or a TPA experience a plus) OR Entry Level Physically fit to carry out duties.   Key benefits/What we offer Our employees play an integral part in our success as a business. We appreciate that each of our employees are unique and have unique needs, ambitions and we enjoy being a part of their journey. We are there to empower and encourage you with your personal and professional development ensuring that you take control by offering a large variety of courses and targeted development programs. All that in a global environment where international mobility and career progression are encouraged. Caring for your health and wellbeing is key priority for us. This is why we build Work Well programs to providing you with peace of mind and give the flexibility in planning and arranging for a better work-life balance. Summary: 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 responsbilities/ What to 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.   Behavioral Requirements/ what to bring • Strong verbal and written communication skills. • Show flexibility, excellent interpersonal skills. • Team Player. • Attention to detail and quality. • Ability to work well with all levels of internal management and staff, as well as outside clients and users. • Ability to train other staff. • The ability to communicate sensitively and effectively with Precertification department and other departments having regard for the strict need for confidentiality. • Experience of working with senior managers and understanding the necessity to act in a pleasant and courteous manner and to be able to work effectively with others. • The ability to exercise initiatives and be able to work flexibly under pressure and to tight deadlines.   Key benefits/What we offer Our employees play an integral part in our success as a business. We appreciate that each of our employees are unique and have unique needs, ambitions and we enjoy being a part of their journey. We are there to empower and encourage you with your personal and professional development ensuring that you take control by offering a large variety of courses and targeted development programs. All that in a global environment where international mobility and career progression are encouraged. Caring for your health and wellbeing is key priority for us. This is why we build Work Well programs to providing you with peace of mind and give the flexibility in planning and arranging for a better work-life balance. Allianz Group is one of the most trusted insurance and asset management companies in the world. Caring for our employees, their ambitions, dreams and challenges, is what makes us a unique employer. Together we can build an environment where everyone feels empowered and has the confidence to explore, to grow and to shape a better future for our customers and the world around us.  We at Allianz believe in a diverse and inclusive workforce and are proud to be an equal opportunity employer. We 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 ethnicity or cultural background, age, gender, nationality, religion, disability or sexual orientation. Great to have you on board. Let's care for tomorrow.
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