Claims Management Coordinator

4 months ago

Doha, Qatar Allianz Partners Full time

**SUMMARY**

Claims Management - Coordinator is responsible for tracking of Direct received from healthcare providers from various claim sources (Physical Documents from courier/messenger, FTP, E-mail, etc.) according to NEXtCARE standards. Claims Management Coordinator tasks include Intimation of received claims statement of account versus processed claims records in the system as well Manual Payment Order generation if required and Payment Order releasing and delivery to Finance or to the respective insurance companies for prompt payment and settlement.

**MAIN TASKS**

Consistently checks and tracks claims received from providers which includes the following responsibilities:
Checks claim submission for proper completion.

Intimation of physical claims versus the statement of account.

Ensures that direct claims submitted by healthcare providers are sorted and segregated per payer.

Ensures that standard format for submission is followed such as general statement of account and detailed statement of account.

Scanning of physical claim documents (Claim Forms, Medical Reports, invoices, etc.).

Archiving of scanned claim documents and FTP Folders.

Ensures feedback within set specified time for any corrections, missing information, and any standard format not being followed by the provider.

Accurate creation of claims batches according to archived and physical claim documents.

Ensures that all claim batches are routed accordingly to next function users (Claims Processing, Medical Review, OFR/Audit)

Ensures that all validated claim batches are created inside the payment order for releasing and delivery to finance and respective insurance companies within the set KPI and NEXtCARE standards.

Ensures that returned Payment Orders for re-evaluation are recorded and endorsed to the concerned department.

Ensures proper documentation, feedback, and endorsement on the following:
Missing information on the claim and standard format of submission are not followed for Network Operations to contact the providers.

Claims with incomplete administrative information to be returned to the provider.

**BEHAVIORAL REQUIREMENTS**
- Attention to detail and ability of multi-task.
- Organizational & time management skills.
- Excellent team player.
- Ability to meet tight deadlines.
- Ability to work under pressure to tight deadlines.
- Strong communication skills.
- Ability to work well with all levels of internal management and staff, as well as outside clients and users.
- Ability to demonstrate sounds work ethics.
- Show flexibility with excellent interpersonal skills.
- Flexible to work in shifting schedule.
- Demonstrate commitment to produce output base results.
- Ability to clearly communicate concepts verbally and in written form is a mandatory requirement for this position.
- Demonstrable commitment to producing output-based results.

**BEHAVIORAL COMPETENCY**

**Customer & Market Excellence**:

- Strive for excellence at every touch point with the customer
- Foster state-of-art technical/operational knowledge and strive for continuous simplification
- Be the benchmark

**Collaborative Leadership**:

- Empower the team and provide purpose and direction
- Develop people, provide feedback and care to employee wellbeing
- Collaborate and exchange best practice.

**Entrepreneurship**:

- Act on opportunities, anticipate trends, take risk, and promote a culture that allows for honest failure
- Take ownership and responsibility
- Embrace innovation and a culture that allows to make decisions without fear of retribution.

**Trust**:

- Act with integrity, honor commitments, tell the truth
- Foster diversity and inclusiveness
- Act transparently and promote corporate social responsibility.

**MINIMUM REQUIREMENTS**
- Bachelor’s Degree; Paramedical background preferred.
- 2+ years filing/documentation experience. Experience within the Health Care Industry, TPA’s, insurance companies, Hospitals, Medical Centers is a plus.
- Physically fit to carry out duties.
- 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
- .

41210 | Operations | Entry Level | Non-Executive | Allianz Partners | Full-Time | Permanent

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.

Join us. Let's care for tomorrow.

Note: Diversity of minds is an int

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