Claims Retrospective Associate

Find more jobs Job Level: Entry Level Location: Area of Expertise: Operations Unit: Allianz Partners Employing Entity: Nextcare Egypt Job Type: Full-Time Remote Job: Hybrid working Employment Type: Permanent ID: 43266 Position Cluster: Key responsibilities/What you do: Evaluate and approve medical requests in line with policy guidelines. Verify the necessity of treatment plans for patients. Regularly enter verbal and written claims approvals. Make approval decisions based on policy terms. Review and decide on high-cost and complex claims. Provide clear, detailed feedback to the Call Centre team’s inquiries. Explain reasons for declined medical claims to clients. Manage workflow efficiently to meet deadlines. Assess claims for eligibility criteria Key requirements/What you bring: Bachelor’s degree in Medicine, Pharmacy, or Dentistry. Minimum of 2 years practical medical experience (experience with reputable insurance providers, brokers, or TPAs is advantageous). Legal authorization to work in the operating country. Proficiency in MS Office (Excel, Word, Outlook, PowerPoint) and strong internet research skills. Excellent verbal and written communication abilities. Demonstrated flexibility and strong interpersonal skills. Collaborative team player. Keen attention to detail and commitment to quality. Capability to work effectively with all management levels, staff, external clients, and users. Experience in training colleagues. Ability to communicate sensitively and confidentially with claims and other departments. Experience collaborating with senior managers, maintaining professionalism and courtesy. Initiative-driven, able to perform under pressure and meet tight deadlines. Key benefits/What we offer: Our employees play an integral part in our success as a business. We appreciate that each of our employees are unique and have unique needs, ambitions and we enjoy being a part of their journey. We are there to empower and encourage you with your personal and professional development ensuring that you take control by offering a large variety of courses and targeted development programs. All that in a global environment where international mobility and career progression are encouraged. Caring for your health and wellbeing is key priority for us. This is why we build Work Well programs to providing you with peace of mind and give the flexibility in planning and arranging for a better work-life balance. 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 shape a better future for our customers. We at Allianz believe in a diverse and inclusive workforce and are proud to be an equal opportunity employer. We encourage you to bring your whole self to work, no matter where you are from, what you look like, who you love or what you believe in. We therefore welcome applications regardless of ethnicity or cultural background, age, gender, nationality, religion, disability, or sexual orientation. Join us. Let's care for tomorrow. Note: Diversity of minds is an integral part of Allianz' company culture. One means to achieve diverse teams is a regular rotation of Allianz Executive employees across functions, Allianz entities and geographies. Therefore, the company encourages its employees to be motivated in gaining varied skills from different positions and to collect experiences from across Allianz Group