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**: