KEY RESPONSIBILITIES/ What You Do

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

• Adjudicate and process Claims within the agreed company SLA - clear to zero, in accordance with policy benefits to facilitate the company achieving its loss ratio target
• Use Allianz Partners client database accurately and effectively to ensure reports generated give a true reflection of the departments workload, which consequently facilitates effective target planning
• Operate within and meet the conditions of company service standards, clear to zero, to guarantee customer satisfaction and retention
• Contribute to the team and departmental productivity targets so that the agreed SLA is achieved and a high level of customer service is provided.
• In line with the companys policy on cost containment identify duplicate payments, overbilling, up coding, possible non-disclosure and fraudulent claims
• Respond to customer enquiries accurately and professionally and if necessary, liaise with other departments for support to ensure an efficient and professional response is given thereby achieving customer satisfaction
• Participate in departmental medical training to expand knowledge of medical terminology and procedures and to develop comprehensive claims processing skills
• Assume additional tasks to effectively support the Team Leader to deliver on team KPIs and deputise for Team Leader, as needed
• Give support and guidance on escalated issues, complaints and challenging claims and lead by example
• 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 your Team Leader to drive engagement within the Team
• Other Ad hoc duties as required
  
  

KEY REQUIREMENTS / What You Bring

• 1-2 years experience in a customer focused environment, ideally in clinical, paramedical roles or TPA or insurance roles.
• Proficiency in MS Office
• Apply Now