Sr Provider Queries Officer

Allianz Partners; Makati; Hybrid; PHP 558,000 - 893,000; Full time

Benefits offered by this job

Competitive Salary

13th and 14th month guaranteed

Performance Incentive Plan / Yearly

Retirement Program and Group Life

Hybrid Work Set-up after 6 months of+

Be part of a pioneer team

Job summary

Allianz Partners in the Philippines seeks a Provider Claims Support Specialist to drive process improvements for providers, TPAs and internal processes. Hospital billing experience is required to assist with complex reconciliations and to deliver accurate responses.

Key responsibilities include managing provider claim queries, ensuring adherence to procedures, and recording all interactions in Salesforce. After 6 months, a hybrid work setup is available.

Qualifications

• Hospital Billing experience is required.
• Medical Claims Processing experience is a plus but not required.
• Strong Excel skills for data analysis and reporting.
• Customer-focused with strong communication.
• Ability to work in a team or independently.

Responsibilities

• Manage Provider Claims queries through eGain delivering best-in-class service.
• Adherence to internal procedures and guidelines, client service agreements and compliance & regulatory standards.
• Own each provider query ensuring right-first-time responses.
• Record and categorize queries in Salesforce with accuracy.
• Escalate invoices outside the Provider’s schedule of fees and investigate discrepancies.
• Support Provider Services with process improvements and reporting to meet SLAs.

Skills

Hospital Billing

Customer focus

Communication skills

Attention to detail

Tools

Microsoft Excel

Job description

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

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

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

• 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 escape 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 proactive
• Ability 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.