Sr. Provider Queries Officer

Allianz Partners; Makati; Hybrid; PHP 335,000 - 558,000; Full time

Benefits offered by this job

Performance Incentive Plan

Yearly Bonus

Retirement Program

Group Life Insurance

Hybrid Work Set-up

Job summary

Allianz Partners seeks a candidate to provide technical expertise in the provider claims area, focusing on process improvements. Key responsibilities include managing provider claims queries, ensuring compliance, and providing clear communication to enhance the provider experience.

This role requires hospital billing experience and strong Microsoft Excel skills. The ideal candidate is customer-focused, works well under pressure, and is motivated and proactive in their approach.

Qualifications

• Hospital Billing experience is required for this role.
• Strong Knowledge of Microsoft Excel and ability to analyze and report on data.
• Medical Claims Processing experience is a plus but not required.
• Ability to work effectively within a team environment & on own initiative.

Responsibilities

• Manage Provider Claims queries ensuring a best-in-class customer service.
• Adhere to internal procedures and compliance standards.
• Provide clear and concise responses in a professional manner.
• Escalate and investigate invoices outside of the Provider's schedule of fees.
• Ensure accurate recording and categorization of all queries.

Skills

Hospital Billing experience

Microsoft Excel

Strong communication

Customer focused

Teamwork

Time management

Ability to work under pressure

Integrity

Motivation

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

Provide technical expertise and support to provider claims area by driving process improvements for providers, TPAs and internal processes. The ability to summarise a situation or problem and suggest solutions. Experience in hospital billing/reconciliation required in order to assist with complex reconciliations

Key Responsibilities

• Manage Provider Claims queries through eGain ensuring a best in class customer service and quality experience is delivered to providers
• Adherence to internal procedures and guidelines, client service agreements and compliance & regulatory standards
• Take ownership of each provider query ensuring all aspects of the query are answered right first time, eliminating rework and increased customer effort
• Provide clear, concise and accurate responses in a professional manner, including internal and external information transfer
• Provide direction, next steps and clear expectations to providers where a query involves further investigation or requires further information
• Contribute to the team and department SLA ensuring query and reconciliation cases are managed efficiently and effectively Ensure priority groups and contractual SLAs are achieved
• Exhibit a proactive approach to Providers, ensuring an ongoing focus on enhancing the Provider experience through process improvements and simplification
• Ensure accurate recording and Categorisation of all queries in Salesforce
• Escalate and investigate invoices submitted outside of the Provider’s schedule of fees
• Identify and escalation any Provider misrepresentation of Invoices on behalf of AWC Members
• Provide support and guidance to the Provider Services Department as required
• Support department and colleagues to ensure overall business targets are achieved
• Other Ad hoc duties as required

Key Requirements

• Hospital Billing experience is required for this role
• Medical Claims Processing experience is a plus but not required
• Strong Knowledge of Microsoft Excel and ability to analyze and report on data
• Customer focused
• Strong communication (verbal & written)
• Ability to work effectively within a team environment & on own initiative
• Honesty and Integrity
• Ability to work under pressure
• Ability to prioritise workload and manage time effectively
• Highly motivated and proactiveAbility to motivate other

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.