Claims Assistant Manager

Job overview

The claims assistant manager is responsible to supervise the processing/documents handling operations for efficient claims monitoring and responding to clients according to set quality and performance standards of the claims management department. The incumbent is also responsible in ensuring flexibility in handling loads and changes in the department, help the team to be client-oriented to deliver quality actions, promote productivity and efficiency product offerings.

What you do

Key responsibilities include:

• Aligning of sales volume and lives with headcount while ensuring the Clear to Zero service level is maintained on a daily basis.
• Ensure productivity of claims officer is appropriate and acceptable as to their level of service, experience and assigned business group or medical provider.
• Ensure the implementation of "Usual and customary rates" with medical providers worldwide.
• Participate in maintaining good relationships with our clients and brokers.
• Liaise with external stakeholders (brokers, group secretaries etc) and other departments (helpline) regarding escalated issues.
• Coach team members to technically assess claims, thereby contributing towards the attainment of targeted decline ratios.
• Work closely with the company medical director.
• Carry out a change management process as required.
• Support the day to day organization of the department through strong man management skills with a focus on cost containment being a key factor.
• Ensure a program of quality is maintained within department.
• In the absence of the claims manager, furnish the head of operations/general manager with weekly claims reports for communication to the EC/BOM and attend the weekly business department update meetings with the head of operations.
• Carry out individual performance management in order to:
  • Maintain and improve individual productivity, quality and decline rate levels;
  • Facilitate an effective flow of information within the department;
  • Foster and maintain staff morale; and
  • Promote staff personal development.
• Carry out regular team meetings to improve internal communication and to support the claims manager by informing staff of departmental policies and protocols. Idea generation and problem solving should be part of such meetings.
• Identify and implement system and process enhancement ideas to maximise productivity and improve the quality of adjudication decisions.
• Actively participate in various operational activities, outside of claims, to ensure that operational service delivery is coordinated to meet and exceed clients' expectations.
• To supervise and ensure the effective management of their assigned claims team to ensure company objectives are achieved. These include "Clear to Zero"; daily closing targets; quality; staff retention and motivation.
• Verify and release processed claims with payment amounts in excess of team leaders to ensure the accurate settlement of high value claims.
• Ensure recruitment is carried out in a timely manner in order that there is minimal operational effect from staff turnover.
• Promote and develop leadership styles, behaviors and technical competencies within team leaders and senior staff.

What you bring

• Degree or relevant professional qualifications in business, operations management.
• Strong knowledge and experience of the medical insurance industry or within a management function of a medical provider.
• Proven record in running and organising a team or department.
• Strong commercial, business knowledge.
• Completion or progression towards the diploma in private medical insurance.
• An ability to communicate effectively, both orally and in writing, in a pressurised working environment.
• Strong strategic and planning skills.
• Effective time management skill.
• Results driven.
• Flexible.
• Ability to be accountable and responsible for decisions.

About Allianz Partners

At Allianz Partners, AI is revolutionizing customer service and claims management through innovative solutions. These AI-driven tools enhance productivity by streamlining complex claims processes, reducing administrative burdens, and accelerating resolution times. Our AI-powered technology has made claims processing faster, offering quicker resolutions, all while ensuring human oversight for claims to maintain service integrity.

By embracing AI and emerging technologies, Allianz Partners continues to lead the industry, meeting ever-changing customer needs with innovative solutions. Our commitment to ethical AI practices safeguards data integrity and trust, ensuring responsible deployment across all operations. This approach not only enhances customer experiences but also supports strategic initiatives like fraud detection and personalized product offerings, solidifying Allianz Partners' position as a leader in the insurance sector.