Claims Management Assessor

Summary: Medical Claims Processing Officer is responsible for Processing the Claims within the regulatory TAT and quality requirements per the assigned checklist and according to Claims Allocation Summary: Medical Claims Processing Officer is responsible for Processing the Claims within the regulatory TAT and quality requirements per the assigned checklist and according to Claims Allocation Main Tasks:

• Operate within and meet the conditions of company service standards, clear to zero, to guarantee customer satisfaction and retention.

• Review and handle claims according to the established standard procedure.

• Support the team and departmental productivity goals to meet the agreed upon Service Level Agreement (SLA) and deliver exceptional customer service

• Provide accurate and professional responses to client inquiries, and if needed, collaborate with other departments to ensure prompt and efficient resolution.

• Engage in departmental medical training to broaden understanding of medical terminology and procedures, and enhance proficiency in claims processing skills.

• Ensures adaptability in various claims handling work-related tasks to be able to facilitate a multi-tasking role.

• Ensures that high quality targets (standard of work performance) are achieved at all times.

• Support the Team Leader to drive engagement within the Team

• Other Ad hoc duties as required

Minimum Requirements:

• Bachelor’s degree in any Medical field, Paramedical, Finance, Business Administration, Insurance, or a related field preferred.

• 1-2 years’ experience in a customer focused environment, ideally in clinical, paramedical roles or TPA or insurance roles.

• Proficiency in MS Office

• A highly customer-focused individual with strong interpersonal, communicative and accuracy skills.

• Team player

• Ability to demonstrate sound work ethics.

• Ability to work under pressure and to meet tight deadlines and service standards

• Legally permitted to work in the country of operations.

• Hybrid working option available as per business requirements.

Main Tasks:

• Operate within and meet the conditions of company service standards, clear to zero, to guarantee customer satisfaction and retention.

• Review and handle claims according to the established standard procedure.

• Support the team and departmental productivity goals to meet the agreed upon Service Level Agreement (SLA) and deliver exceptional customer service

• Provide accurate and professional responses to client inquiries, and if needed, collaborate with other departments to ensure prompt and efficient resolution.

• Engage in departmental medical training to broaden understanding of medical terminology and procedures, and enhance proficiency in claims processing skills.

• Ensures adaptability in various claims handling work-related tasks to be able to facilitate a multi-tasking role.

• Ensures that high quality targets (standard of work performance) are achieved at all times.

• Support the Team Leader to drive engagement within the Team

• Other Ad hoc duties as required

Minimum Requirements:

• Bachelor’s degree in any Medical field, Paramedical, Finance, Business Administration, Insurance, or a related field preferred.

• 1-2 years’ experience in a customer focused environment, ideally in clinical, paramedical roles or TPA or insurance roles.

• Proficiency in MS Office

• A highly customer-focused individual with strong interpersonal, communicative and accuracy skills.

• Team player

• Ability to demonstrate sound work ethics.

• Ability to work under pressure and to meet tight deadlines and service standards

• Legally permitted to work in the country of operations.

• Hybrid working option available as per business requirements.

Job Level: Entry Level Location: Riyadh, SA Area of Expertise: Customer Services & Claims Unit: Allianz Partners Employing Entity: Nextcare Saudi Arabia Job Type: Full-Time Remote Job: 100% on-site Employment Type: Permanent ID: 43450 Position Cluster: