Medical Claims Officer

NEXTCARE Claims Management LLC; Dubai; On-site; AED 60,000 - 100,000; Full time

Job summary

An established industry player is seeking a Medical Claims Officer to provide exceptional service in claims processing and management. This role involves evaluating claims, making decisions on complex cases, and coordinating with international providers. The ideal candidate will possess a Bachelor’s of Medicine and demonstrate strong organizational, interpersonal, and communication skills. Join a forward-thinking company that values diversity and inclusion, and be part of a team dedicated to excellence and innovation in the healthcare sector. Your contributions will play a vital role in enhancing client satisfaction and operational efficiency.

Qualifications

• Bachelor’s of Medicine (MBBS) required with medical practical experience.
• Fluency in MS Office and strong communication skills are essential.

Responsibilities

• Manage daily claims administration and evaluate claims for eligibility.
• Handle international preauthorization cases and improve service efficiency.

Skills

Organizational skills

Time management skills

Interpersonal skills

Communication skills

Problem-solving skills

Education

Bachelor’s of Medicine (MBBS)

Tools

MS Office (Excel, Word, Outlook, PowerPoint)

Job description

The Medical Claims Officer will provide quality service to clients, promptly and effectively assess and process claims and approval according to operations set standards.

MAIN TASKS

1. Manages routine daily claims administration work.
2. Evaluates claims with regards to eligibility.
3. Takes decisions on high cost and complicated cases based on standard operating procedures.
4. Handles International Preauthorization cases as required.
5. Attends calls and e-mails from insurance companies, clients, and providers.
6. Coordinates with international providers for direct billing.
7. Makes suggestions to improve service.
8. Increases efficiency, minimizes errors and administration time.

BEHAVIORAL REQUIREMENTS

1. Organizational & time management skills.
2. Excellent team player.
3. Ability to work well with all levels of internal management and staff, as well as outside clients and users.
4. Ability to demonstrate sound work ethics.
5. Show flexibility with excellent interpersonal skills.
6. The ability to communicate sensitively and effectively with claims department and other departments having regard for the strict need for confidentiality.
7. To be capable of responding diplomatically to pressures and problems showing a calm approach to working towards deadlines and always able to show an innovative and creative approach to work.
8. The ability to exercise initiatives and be able to work flexibly under pressure and to tight deadlines.
9. 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.

BEHAVIORAL COMPETENCY

Customer & Market Excellence :

1. Strive for excellence at every touch point with the customer.
2. Foster state-of-art technical / operational knowledge and strive for continuous simplification.
3. Be the benchmark.
4. Empower the team and provide purpose and direction.
5. Develop people, provide feedback and care to employee wellbeing.
6. Collaborate and exchange best practice.
7. Act on opportunities, anticipate trends, take risk, and promote a culture that allows for honest failure.
8. Take ownership and responsibility.
9. Embrace innovation and a culture that allows to make decisions without fear of retribution.

Trust :

1. Act with integrity, honor commitments, tell the truth.
2. Foster diversity and inclusiveness.
3. Act transparently and promote corporate social responsibility.

MINIMUM REQUIREMENTS

1. Bachelor’s of Medicine (MBBS) only.
2. Medical Practical Experience (reputable insurance provider, broker or a TPA experience a plus).
3. Physically fit to carry out duties.
4. Legally permitted to work in the country of operations.
5. Fluency in MS Office (Excel, Word, Outlook, PowerPoint) and general internet navigation and research skills.

44265 | Operations | Professional | [[custPositionClusterCSB]] | Allianz Partners | Full-Time | Permanent

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 shape a better future for our customers.

We at Allianz believe in a diverse and inclusive workforce and are proud to be an equal opportunity employer. We encourage you to bring your whole self to work, no matter where you are from, what you look like, who you love or what you believe in.

We therefore welcome applications regardless of ethnicity or cultural background, age, gender, nationality, religion, disability, or sexual orientation.

Join us. Let's care for tomorrow.

Note : Diversity of minds is an integral part of Allianz' company culture. One means to achieve diverse teams is a regular rotation of Allianz Executive employees across functions, Allianz entities and geographies. Therefore, the company encourages its employees to be motivated in gaining varied skills from different positions and to collect experiences from across Allianz Group.