Job description / Role
The role of Claims Officer involves processing medical claims for clients worldwide. We ensure a high level of client service while processing claims within an industry leading 48 hours. The Claims Department is a very fast paced and challenging environment, with many different languages used and a mixture of cultures.
Key responsibilities will include, but are not limited to, the following:
- Adjudicate and process Claims within the agreed company SLA - clear to zero, in accordance with policy benefits to facilitate the company achieving its loss ratio target
- Use AWC's client database accurately and effectively to ensure reports generated give a true reflection of the department's workload, which consequently facilitates effective target planning
- Operate within and meet the conditions of company service standards, clear to zero, to guarantee customer satisfaction and retention - Contribute to the team and departmental productivity targets so that the agreed SLA is achieved and a high level of customer service is provided.
- In line with the company's policy on cost containment identify duplicate payments, possible non-disclosure and fraudulent claims
- Respond to customer enquiries accurately and professionally and if necessary, liaise with other departments for support to ensure an efficient and professional response is given thereby achieving customer satisfaction
- Participate in departmental medical training to expand knowledge of medical terminology and procedures and to develop comprehensive claims processing skills
- Other Ad hoc duties as required
Requirements
- Experience working in Claims Department
- Fluency in English and a second language preferably
- Ability to work under pressure and to meet tight deadlines and service standards - Customer focused
- Strong communication (verbal & written)
- Ability to work effectively within a team environment
- Honesty and Integrity
- Ability to work under pressure
- Ability to prioritise workload, Flexible and manage time effectively
- Highly motivated and proactive
About the Company
With over 159,000 employees from 172 nationalities across more than 70 countries, we are one of the world's most trusted insurance and asset management companies. We offer a broad range of products and services in property/casualty insurance, life/health insurance, and asset management. We have our largest operational presence in Europe, and our parent company, Allianz SE, is headquartered in Munich, Germany. From jobs in Actuarial, Business and IT to Inhouse Consulting and Investment Management - your opportunities are endless!