Medical Claims Officer

Cairo, Egypt

Ref: SP864-361

Job description / Role

Job Type
Full Time

Job Location
Cairo, Egypt

Nationality
Any Nationality

Salary
Not Specified

Gender
Not Specified

Arabic Fluency
Not Specified

Job Function
Healthcare

Company Industry
Insurance

Summary

Medical claims officer provides quality service to clients, promptly and effectively assesses and processes claims and approvals 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.

What to do

Assesses approval of medical approvals as well as policy use.

Channels medical claims officers in handling difficult medical cases and optimizes the quality and quantity output.

Monitors daily output on the number of cases done and decrease in number of errors committed.

Provides second opinion for cases where there is doubt in treatment plan.

Assesses high cost claims and provides 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 workflow and meets deadlines.

Provides on job training to team members as necessary.

What you 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 initiative and be able to work flexibly under pressure and to tight deadlines.

Bachelor of Pharmacy.

Medical practical experience (reputable insurance provider, broker or a TPA experience a plus) or entry level.

Physically fit to carry out duties.

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 a key priority for us. This is why we build work well programs to provide you with peace of mind and give the flexibility in planning and arranging for a better work-life balance.

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!

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