Claims Processing Officer

Key responsibilities/What you do:

• Audit and process all types of providers’ bills.
• Examine claim documents thoroughly.
• Ensure correct pricing is applied before processing bills in TATSH.
• Handle claim adjustments.
• Utilize AI-based screening tools to verify accurate entry of insurance claim information, ensuring precise processing and timely payment.
• Verify all required fields in TATSH, such as visa notes, precertification center notes, contract notes, policy files, medical files, and faxes, to guarantee accurate processing.
• Process and record invoice details in TATSH according to policy terms, product type, TOB, and information from medical auditors, providers, and precertification officers.
• Follow up daily on pending claims or issues with relevant departments until resolved.
• Notify the Network department upon receiving jumbo claims to secure special discounts from providers.
• Report in writing to the Network department any deviations from agreed tariffs by providers.
• Inform the Team Leader or Manager in writing about complaints related to payers’ or providers’ invoices received by the Claims Processing department.
• Communicate in writing to the Team Leader or Manager any requests or information needed from other departments.
• Adhere strictly to the Department’s internal procedures.
• Maintain confidentiality and proper management of insured member data, system information, policies, and medical records.
• Perform any other duties assigned by the Direct Manage
• 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:

• Education: Pharmacy Degree.
• Experience: Minimum 2 years in the Health Care Industry, including TPA’s, insurance companies, hospitals, or medical centers.
• Strong commitment to delivering results.
• Ability to meet deadlines consistently.
• Excellent teamwork skills.
• Outstanding communication and organizational abilities.
• Flexibility to work shifts.
• Willingness to work overtime when necessary.
• Basic proficiency in MS Office applications

How we hire 
 
Agency Statement 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

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. 

At Allianz, we stand for unity: we believe that a united world is a more prosperous world, and we are dedicated to consistently advocating for equal opportunities for all. And the foundation for this is our inclusive workplace, where people and performance both matter, and nurtures a culture grounded in integrity, fairness, inclusion and trust. 

We therefore welcome applications regardless of ethnicity or cultural background, age, gender, nationality, religion, social class, disability or sexual orientation, or any other characteristics protected under applicable local laws and regulations. 

Great to have you on board. Let's care for tomorrow. 

Note: Having different strengths, experiences, perspectives and approaches is an integral part of Allianz‘ company culture. One means to achieve this is a regular rotation of Allianz Executive employees across functions, Allianz entities and geographies. Therefore, the company expects from its employees a general openness and a high motivation to regularly change positions and collect experiences across Allianz Group.