Claims Processing Officer, Allianz

Allianz

Location:
Egypt, Cairo

Category:
Insurance

Contract Type:
Employment contract

Salary:

Not provided

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Job Description:

The Claims Processing Officer evaluates and audits providers’ bills and processes them on the system. He / She performs scan for detection of missing documents and ensures that medical report, prescription/tests/invoices are coherent.

Job Responsibility:

Audit and process all kinds of providers’ bills
Screen claim documents
Ensure that proper pricing is applied for bills before processing them in TATSH
Process claim adjustment
Ensure that insurance claims information is entered into the system correctly, to ensure accurate processing and timely delivery to payers
Check all required fields on TATSH for accurate processing such as visa notes, precertification centre notes, contract notes, policy file, medical file, faxes, etc.
Process and record details of the invoice on TATSH in accordance with policy terms and conditions, product, TOB, and other relevant details
Daily follow up on pending claims/issues with concerned departments until problem resolution
Inform Network department when receiving a jumbo claim to obtain a special discount from providers
Report in writing to the Network department regarding any deviation from the provider concerning the application of the agreed tariff
Report in writing to the Team Leader/Manager regarding complaints received by the Claims Processing department relating to payers/providers invoices
Report in writing to the Team Leader/Manager regarding any information/task required from other departments
Follow and apply the internal procedures of the Department
Responsible and accountable for the confidential, proper administration of insured member data as well as system, policy, and medical information
Perform any other duties as requested by the Direct Manager

Requirements:

Baccalaureate Degree or equivalent
2+ years experience within the Health Care Industry (TPA’s, Insurance companies, Hospitals, Medical Centers)
Demonstrate commitment to producing output base results
Ability to respect deadlines
Excellent team player
Excellent communication and organizing skills
Flexible and ability to work shift
Willing to work overtime when requested
Basic knowledge of MS Office applications

What we offer:

Dynamic and Multinational working environment
Trainings and programs dedicated to Learning and Development (e.g., free access to LinkedIn Learning)
A wide range of employee benefits such as performance bonus, health insurance
Modern Offices

Additional Information:

Job Posted:
May 12, 2025

Employment Type:

Fulltime

Work Type:

Hybrid work

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Claims Processing Officer