Medical Claims Lead

Job description / Role

We are Allianz Partners. The leader in assistance and insurance solutions in the areas of international health, assistance, automotive and travel insurance. Allianz Partners is a global family of over 19,000 employees across 78 countries. This role is in the International Health part of the business, which has a number of well-known customer facing brands such as Allianz Care, Nextcare and Medi24.

The International Health line of business provides international health, life and disability insurance and services, reinsurance and administration services to a wide range of customers. These include multinational companies, intergovernmental organisations (IGOs), non-governmental organisations (NGOs), private individuals, families and students. Our mission is to ensure that customers have access to quality healthcare through our support, care and commitment to go the extra mile. We are a truly global health partner for our customers, ensuring fast and simple access to the best advice, treatment and value for our customer.

Medical Claims Lead will evaluate complicated IP- claims, medical evaluations of complex direct claims coverage, review errors, and process queries to achieve quality evaluations.

Main Tasks

- Coordinates work flow & meet deadlines.
- Evaluates IP and complex claims with regards to eligibility and medical necessity.
- Cost Containment and utilization review of high cost claims bills
- Makes informed decisions on high cost and complicated cases.
- Attends calls and e-mails from insurance companies, clients and providers.
- Makes suggestions to improve service.
- Increases efficiency, minimizes errors and administration time.

- Bachelor's of Medicine ( MBBS ).
- 2+ years Medical Practical Experience (reputable insurance provider, broker or a TPA experience a plus).
- Physically fit to carry out duties.
- Legally permitted to work in the country of operations.
- Fluency in MS Office (Excel, Word, Outlook, PowerPoint) and general internet navigation and research skills.
- Requires strong computer skills.
- Verbal and written communication skills.
- Show flexibility, excellent interpersonal skills.
- Project coordination experience.
- Ability to work well with all levels of internal management and staff, as well as outside clients and users
- Ability to train other staff.
- Strong negotiations and presentation skills.

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!