Claims Officer

Allianz Partners; Makati; On-site; PHP 279,000 - 390,600; Full time

Benefits offered by this job

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 summary

Allianz Partners in Makati is seeking a Claims Officer responsible for processing medical claims efficiently within 48 hours while ensuring high client satisfaction. The role requires collaboration in a fast-paced environment and excellent communication skills.

Applicants should have 1-2 years of experience in medical claims, be fluent in English, and possess strong Microsoft Office skills. A hybrid work setup is available after 6 months of employment.

Qualifications

• 1-2 years experience in a Medical Claims role is required.
• Ability to demonstrate sound work ethics.
• Can work with minimal supervision and is comfortable working with deadlines.

Responsibilities

• Examine and process Claims within the company SLA.
• Use Allianz Partners client database to ensure accurate reporting.
• Identify duplicate payments and possible fraudulent claims.
• Respond to customer enquiries professionally.

Skills

Microsoft Office (Excel, Word)

Customer-focused interpersonal skills

Accuracy skills

Team player

Ability to work with minimal supervision

Fluent English

Job description

Benefits/Perks

• 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, ensuring that services are eligible as per policy terms and conditions, are in correlation with the authorized guarantee of payment, 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

• 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 sound work ethics
• Can work with minimal supervision and comfortable working with deadlines
• Must be willing to work onsite in Makati for the first 6 months
• Fluent English

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.