Claims Officer

Allianz; Makati; On-site; Confidential; Full time

Benefits offered by this job

Competitive salary

13th month

14th month

Yearly bonus

Retirement program

Group life insurance

Hybrid work after 6 months

Pioneer team

Job summary

Allianz Group is seeking a Claims Officer to process medical claims for clients in the assigned region, ensuring service within 48 hours and strict adherence to policy terms. You will verify eligibility and calculate payments with accuracy.

The role operates in a fast-paced, multilingual environment. You will be onsite in Makati for the first 6 months, then hybrid, using Allianz Partners' client database to generate reports and maintain high client satisfaction.

Qualifications

• 1-2 years experience in Medical Claims role required.
• Strong knowledge of Microsoft Office (Excel, Word).
• Fluent English with good communication skills.
• Willing to work onsite in Makati for the first 6 months.

Responsibilities

• Examine and process Claims within the agreed company SLA to guarantee customer satisfaction and retention.
• Use Allianz Partners client database accurately and effectively to ensure reports generated reflect workload and aid planning.
• Contribute to team and departmental productivity targets to meet SLA.
• Identify duplicate payments, overbilling, upcoding, possible non-disclosure and fraudulent claims as per policy.
• Respond to customer enquiries accurately and liaise with other departments for efficient responses.

Skills

Medical claims knowledge

Customer service

Interpersonal skills

Attention to detail

Team player

Tools

Microsoft Excel

Microsoft Word

Job description

BENEFITS/PERKS

• Competitive Salary
• 13th and 14th month guaranteed
• Performance Incentive Plan / Yearly Bonus
• Retirement Program and Group Life Insurance
• Hybrid Work Set-up after 6 months of employment
• Be part of a pioneer team

JOB DETAILS / ROLE PURPOSE

The role of Claims Officer involves processing medical claims for clients in their assigned region. We ensure a high level of client service while processing claims within an industry leading 48 hours.

The Claims Officer will process Medical Providers’ Claims, making sure that services are eligible as per policy terms and conditions, are in correlation with the authorized guarantee of payment given and are paid as per the agreed tariffs with providers.

The Claims Department is an extremely fast paced environment, with many different languages used and a mixture of cultures.

KEY RESPONSIBILITIES

Key responsibilities will include, but are not limited to, the following:

• Examine and process Claims within the agreed company SLA to guarantee customer satisfaction and retention
• Use Allianz Partners client database accurately and effectively to ensure reports generated give a true reflection of the department’s workload, which consequently facilitates effective target planning
• Contribute to the team and departmental productivity targets so that the agreed SLA is achieved
• In line with the company’s policy on cost containment identify duplicate payments, overbilling, up coding, 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

KEY REQUIREMENTS

• 1-2 years experience in a Medical Claims role is required
• Strong Knowledge of Microsoft Office (Excel, Word)
• A highly customer-focused individual with strong interpersonal, communicative and accuracy skills.
• Team player
• Ability to demonstrate sounds work ethics.
• Can work with minimal supervision and comfortable working with deadlines
• Must be willing to work onsite in Makati first 6 months
• Fluent English

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 to shape a better future for our customers and the world around us.

At Allianz, we stand for unity: we believe that a united world is a more prosperous world, and we are dedicated to consistently advocating for equal opportunities for all. And the foundation for this is our inclusive workplace, where people and performance both matter, and nurtures a culture grounded in integrity, fairness, inclusion and trust.

We therefore welcome applications regardless of ethnicity or cultural background, age, gender, nationality, religion, social class, disability or sexual orientation, or any other characteristics protected under applicable local laws and regulations.

Join us. Let's care for tomorrow.