Claims Reconciliation Medical officer

Job description / Role

The Senior Claims Reconciliation Medical Officer - will assess from a medical perspective the Provider claims and compare their usual reasonable customary standards versus medical practices and market law.

Key Responsibilities/ what you do
- Manages routine daily claims adjudication work.
- Coordinates work flow & meet deadlines.
- Evaluates claims with regards to eligibility and medical standards
- Takes decisions on high cost and complicated cases based on standard operating procedures.
- Investigate disputed rejected claims and respond with the appropriate justification
- Attends calls and e-mails from insurance companies, clients, and providers.
- Analyze reconciliation files and create summary with recommendation and action to reduce conflicting decisions with the Providers
- Increases efficiency, minimizes errors and administration time.

Key Requirements / what you bring

- Bachelor's of Medicine (MBBS).
- Medical Practical Experience (reputable insurance provider, broker or a TPA experience a plus).
- Physically fit to carry out duties.
- Legally permitted to work in the country of operations.
- Fluency in MS Office (Excel, Word, Outlook, PowerPoint) and general internet navigation and research skills

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.

About the Company

With over 159,000 employees from 172 nationalities across more than 70 countries, we are one of the world's most trusted insurance and asset management companies. We offer a broad range of products and services in property/casualty insurance, life/health insurance, and asset management. We have our largest operational presence in Europe, and our parent company, Allianz SE, is headquartered in Munich, Germany. From jobs in Actuarial, Business and IT to Inhouse Consulting and Investment Management - your opportunities are endless!