Sr. Provider Queries Officer

Allianz

Makati

Hybrid

PHP 400,000 - 640,000

Full time

14 days+
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Benefits offered by this job

Competitive Salary
13th/14th Month
Yearly Bonus
Retirement Program
Group Life Insurance
Hybrid Work after 6 months
Pioneer team

Job summary

Allianz Philippines invites applications for a Provider Claims Support role based in Makati. The candidate will drive process improvements for providers, TPAs, and internal processes, focusing on hospital billing and reconciliation expertise to support complex invoicing tasks.

The role requires strong Excel analysis, teamwork, and customer-focused communication. A hybrid work setup is available after six months, with a pathway to contribute to a pioneer team shaping provider services.

Qualifications

  • Hospital billing experience is required.
  • Experience with medical claims processing is a plus.
  • Strong Excel skills and data analysis capability.
  • Customer-focused with strong verbal and written communication.
  • Ability to work in and with a team, and on own initiative.

Responsibilities

  • Manage provider claims queries via eGain ensuring excellent service.
  • Ensure compliance with procedures and client service agreements.
  • Own each query and provide right-first-time responses.
  • Provide clear, concise information and transfer when needed.
  • Escalate/investigate invoices outside the provider's fee schedule.
  • Record and categorize queries in Salesforce.
  • Support Provider Services and team targets.

Skills

Hospital billing
Microsoft Excel
Customer focus
Communication
Teamwork
Integrity
Time management
Proactive mindset

Tools

eGain
Salesforce

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 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.

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