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account manager

claims reconciliation officer

Nextcare

<div>
 
 
 Key Responsibilities
 
 /What You Do
 
 
 
 <ul>
 <li>
 Review and analyze claims to ensure they are accurate and complete.
 </li>
 <li>
 Process claims adjustments and corrections as necessary.
 </li>
 <li>
 Reconcile claims data with financial records and systems.
 </li>
 <li>
 Identify and investigate discrepancies in claims transactions and ensure timely and accurate reconciliation of claims.
 </li>
 <li>
 Analyze claims data to identify trends and patterns.
 </li>
 <li>
 Prepare reports and presentations on claims performance and reconciliation outcomes.
 </li>
 <li>
 Utilize data analytics tools to improve the efficiency of the claims reconciliation process.
 </li>
 <li>
 Assist in internal and external audits related to claims and reconciliation.
 </li>
 <li>
 Maintain accurate and organized documentation for audit purposes.
 </li>
 <li>
 Work closely with the finance, processors, and customer service departments to resolve claims issues.
 </li>
 <li>
 Communicate effectively with stakeholders to address and resolve claims discrepancies.
 </li>
 <li>
 Handle and support direct communication with the healthcare providers on their rejection ratio and reconciliation review findings.
 </li>
 <li>
 Conduct Reconciliation meetings with the stakeholders as required by the reconciliation process.
 </li>
 <li>
 Other Ad hoc duties as required
 
 
 </li>
 </ul>
 
 AI READINESS
 
 Work effectively in an environment shaped by artificial intelligence (AI), machine learning, data analytics and cloud-based tools, using insights responsibly with our standards of data governance, security and ethical use
 
 
 
 Key Requirements/What You Bring
 
 
 
 <ul>
 <li>
 Bachelor&rsquo;s degree in any Medical field, Finance, Business Administration, Insurance, or a related field preferred.
 </li>
 <li>
 Minimum of 2-3 years of experience in claims reconciliation, financial analysis, or a similar role.
 </li>
 <li>
 Experience in the insurance or healthcare industry is preferred.
 </li>
 <li>
 Strong analytical and problem-solving skills.
 </li>
 <li>
 Proficiency in Microsoft Excel and other data analysis tools.
 </li>
 <li>
 Excellent attention to detail and accuracy.
 </li>
 <li>
 Strong organizational and time management skills.
 </li>
 <li>
 Ability to work independently and as part of a team.
 </li>
 <li>
 Excellent written and verbal communication skills.
 </li>
 <li>
 Familiarity with claims processing systems and software.
 </li>
 <li>
 Understanding of regulatory requirements related to claims and reconciliation.
 </li>
 <li>
 Knowledge of accounting principles and practices.
 </li>
 <li>
 Legally permitted to work in the country of operations.
 </li>
 <li>
 Hybrid working option available as per business requirements.
 
 
 </li>
 </ul>
 
 How we hire
 
 Allianz Partners does not accept unsolicited CV&rsquo;s or approaches from agencies. We only work with partners on our approved supplier list, under contract. Any unsolicited submission will not be considered.
 
 
 
 Key Benefits/What We Offer
 
 
 
 Allianz Partners is a world leader in B2B2C insurance and assistance, offering global solutions that span international health and life, travel insurance, automotive and assistance. Customer driven, our innovative experts are redefining insurance services by delivering future-ready, high-tech high-touch products and solutions that go beyond traditional insurance.
 
 
 Our products are embedded seamlessly into our partners&rsquo; businesses or sold directly to customers and are available through four commercial brands: Allianz Assistance, Allianz Automotive, Allianz Travel and Allianz Care. Present in 75 countries, our 21,100 employees speak 70 languages, handle over 71 million cases each year, and are motivated to go the extra mile to offer peace of mind to our customers around the world.
 
 
 We at Allianz believe in a strong inclusive culture that encourages people to speak their minds, get involved and question the status quo. We are proud to be an equal opportunity employer and 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.
 
 
 We therefore welcome applications regardless of race, ethnicity or cultural background, age, gender, nationality, religion, social class, disability, sexual orientation, or any other characteristics protected under applicable local laws and regulations.
 
 
 At Allianz Partners, AI is revolutionizing customer service and claims management through innovative solutions. These AI-driven tools enhance productivity by streamlining complex claims processes, reducing administrative burdens, and accelerating resolution times. Our AI-powered technology has made claims processing faster, offering quicker resolutions. All while ensuring human oversight for claims to maintain service integrity. By embracing AI and Emerging Technologies, Allianz Partners continues to lead the industry, meeting ever-changing customer needs with innovative solutions. Our commitment to Ethical AI practices safeguards data integrity and trust, ensuring responsible deployment across all operations. This approach not only enhances customer experiences but also supports strategic initiatives like fraud detection and personalized product offerings, solidifying Allianz Partners' position as a leader in the insurance sector.
 
 
 Great to have you on board. Let's care for tomorrow.
</div>

Claims Reconciliation Officer

Liva Insurance UAE

<div>
 
 The ideal candidate will be involved with preparing financial reports and statements, bank reconciliations, and conducting cyclical audits. Moreover, the candidate must have strong interpersonal skills and possess a strong business acumen.
 
 
 
 
 
 
 Responsibilities
 
 
 <ul>
 <li>
 Prepare and manage all accounting transactions for Bahrain
 </li>
 <li>
 Preparing of standard Journal Vouchers to account the RI premium, RI claims, Adjustment and others.
 </li>
 <li>
 Preparing Adjustment Credit / Debit Notes, provision, prepayment entry into Jupiter system on quarterly basis
 </li>
 <li>
 Preparing Payment vouchers in Jupiter for Bahrain Business ( supplier, Vendor, Garages, Customer, Reinsurance , Broker or any corporate clients.
 </li>
 <li>
 Preparing manually CHQ payment to all supplier, Vendor, Garages, Customer, Broker or any corporate clients.
 </li>
 <li>
 Preparing Bank slips in all received CHQ from Broker and deposit them into account on daily basis.
 </li>
 <li>
 Preparing Bank Transfer payment through Banks
 </li>
 <li>
 Preparing of the reconciliation between GL and subsidiary ledgers
 </li>
 <li>
 Preparing of monthly customer statements outstanding amount and following up on outstanding debts
 </li>
 <li>
 Prepare reconciliation with Broker / Corporate customer for any discrepancies amount whenever needed
 </li>
 <li>
 Preparing all receipt voucher on daily basis
 </li>
 <li>
 Collecting all cash report daily basis from Underwriter team
 </li>
 <li>
 Following up with banks on direct deposits once maturity becomes due.
 </li>
 <li>
 Create new entity codes / Tag code into system ( Broker, Agent, customer, repairer &hellip;etc)
 </li>
 <li>
 Preparing all intercompany transactions that need to be booked into system.
 </li>
 <li>
 Ensure monthly reconciliation of premium, commission &amp; claims and sign-off by authorized signatory.
 </li>
 <li>
 Performing monthly petty cash counts and ensuring it agrees to the TB and reimbursed amount.
 </li>
 <li>
 Preparing bank reconciliation on monthly basis
 </li>
 <li>
 Support on Handle monthly closing report that need to close month end.
 </li>
 <li>
 Maintaining filling system in to finance department include ( RV, PV, JV, FAV, &hellip;etc)
 </li>
 <li>
 Assist Regional CFO, Head of Finance UAE &amp; Bahrain, and Finance manager in any adhoc request.
 </li>
 </ul>
 <li>
 </li>
 
 
 
 
 
 Qualifications
 
 
 
 
 
 <ul>
 <li>
 Bachelor's degree in accounting, finance or related fields.
 </li>
 <li>
 CPA /CMA/ CIA/ ACCA/ MBA &ndash; Optional
 </li>
 <li>
 Minimum
 
 of 2 years
 
 of experience in the insurance sector
 </li>
 </ul>
 
 
 
 
 
 Key Competencies &amp; Skills
 
 
 
 
 
 <ul>
 <li>
 Ability to work effectively within a team environment
 </li>
 <li>
 Proficiency in Windows-based software, with strong
 
 Excel skills
 
 </li>
 <li>
 
 Arabic Speaker, Prefer Bahraini
 
 </li>
 </ul>
</div>

Accountant

<div>
 The main duty of a Customer Care Unit Officer is to respond to communication inquiries / complaints raised by members, providers, brokers, and payers as per the standard procedures. The incumbent is also responsible to ensure that all cases are responded within predetermined time scales and are dealt with the highest standards of customer service. The CCU Officer will also document details of all cases and actions taken, in order to make further follow-ups and corrective action as required. The CCU Officer will correspond with Care Center Management accordingly and comply to provide a customer-oriented service at all times.
 
 
 
 
 Key Responsibilities
 
 /What You Do
 
 
 
 <ul>
 <li>
 Closely coordinate with Payers, Providers and Members by providing quality actions and resolutions to their concerns and queries.
 </li>
 <li>
 Proactively handle complaints at the earliest.
 </li>
 <li>
 Follow communication/update expectations with clients, in accordance with NEXtCARE policies, scheme or agreed time frames set.
 </li>
 <li>
 Answer inbound Emails as well as assist customers who have specific inquiries
 </li>
 <li>
 Build customer&rsquo;s interest in the services and products offered by the company
 </li>
 <li>
 Provide personalized customer service of the highest level
 </li>
 <li>
 Update the existing database with changes and the status of each existing/prospective customer/member
 </li>
 <li>
 Document details of all conversation and actions taken.
 </li>
 <li>
 Correspond with Care Centre Management and keep an open channel of communication.
 </li>
 <li>
 Maintaining records and close-loop each call by completing the clerical duties which includes faxing, filling up paperwork, doing checks on credit references, as well as liaising with other departments
 </li>
 <li>
 Analyze the various parts of a problem properly and develop logical solutions within the permitted scope of work.
 </li>
 <li>
 Efficiently adjudicate pre-approval claims that exceed the standard Turnaround Time (TAT) to ensure timely resolution.
 </li>
 <li>
 Issue Guarantee of Payment (GOP) documents as required to facilitate seamless service delivery.
 
 
 </li>
 </ul>
 
 AI READINESS
 
 Work effectively in an environment shaped by artificial intelligence (AI), machine learning, data analytics and cloud-based tools, using insights responsibly with our standards of data governance, security and ethical use.
 
 
 
 Key Requirements/What You Bring
 
 
 
 <ul>
 <li>
 Bachelors Degree ; Medical background (Medical, Paramedical)
 </li>
 <li>
 2+ years experience in a Call Centre/ Customer Service environment, TPA Hospitals or Medical Centers exposure a plus.
 </li>
 <li>
 Physically fit to carry out duties.
 </li>
 <li>
 Legally permitted to work in the country of operations.
 </li>
 <li>
 Fluency in MS Office (Excel, Word, Outlook, PowerPoint) and general internet navigation and research skills.
 </li>
 <li>
 Excellent customer service and support skills.
 </li>
 <li>
 Excellent Arabic &amp; English language skills
 
 
 </li>
 </ul>
 
 How we hire
 
 Allianz Partners does not accept unsolicited CV&rsquo;s or approaches from agencies. We only work with partners on our approved supplier list, under contract. Any unsolicited submission will not be considered.
 
 
 Allianz Partners is a world leader in B2B2C insurance and assistance, offering global solutions that span international health and life, travel insurance, automotive and assistance. Customer driven, our innovative experts are redefining insurance services by delivering future-ready, high-tech high-touch products and solutions that go beyond traditional insurance.
 
 
 Our products are embedded seamlessly into our partners&rsquo; businesses or sold directly to customers and are available through four commercial brands: Allianz Assistance, Allianz Automotive, Allianz Travel and Allianz Care. Present in 75 countries, our 21,100 employees speak 70 languages, handle over 71 million cases each year, and are motivated to go the extra mile to offer peace of mind to our customers around the world.
 
 
 We at Allianz believe in a strong inclusive culture that encourages people to speak their minds, get involved and question the status quo. We are proud to be an equal opportunity employer and 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.
 
 
 We therefore welcome applications regardless of race, ethnicity or cultural background, age, gender, nationality, religion, social class, disability, sexual orientation, or any other characteristics protected under applicable local laws and regulations.
 
 
 At Allianz Partners, AI is revolutionizing customer service and claims management through innovative solutions. These AI-driven tools enhance productivity by streamlining complex claims processes, reducing administrative burdens, and accelerating resolution times. Our AI-powered technology has made claims processing faster, offering quicker resolutions. All while ensuring human oversight for claims to maintain service integrity. By embracing AI and Emerging Technologies, Allianz Partners continues to lead the industry, meeting ever-changing customer needs with innovative solutions. Our commitment to Ethical AI practices safeguards data integrity and trust, ensuring responsible deployment across all operations. This approach not only enhances customer experiences but also supports strategic initiatives like fraud detection and personalized product offerings, solidifying Allianz Partners' position as a leader in the insurance sector.
 
 
 Great to have you on board. Let's care for tomorrow.
</div>

Customer Care Officer

Jobs via eFinancialCareers

<div>
 Bank ABC seeks to recruit an IFRS9 &amp; ECL Reporting Officer in the Group Risk Management Department based in our Head Office, in Bahrain.
 
 
 The primary responsibility of this role involves running the Moodys IFRS9 RCO on several environments / contexts for different units/subsidiaries as applicable
 
 
 Regularly maintaining, updating, and monitoring the Expected Credit Loss (ECL) framework, including the calculation rules and engines in line with internal policies and regulatory requirements.
 
 
 The role requires a sound understanding of SQL and related database technologies and a high-level familiarity with statistical tools such as SA. A strong knowledge of IFRS9 guidelines, Basel guidelines, and credit risk management tools is essential
 
 
 
 Responsibilities of the role:
 
 
 
 Reporting to the Head of IFRS9 &amp; ECL Reporting, the job holder will be responsible for:
 
 
 <ul>
 <li>
 Generation of IFRS9 ECL provision results on a quarterly basis through the Moodys RCO for both Group and Unit levels using different environments/contexts.
 </li>
 <li>
 Engaging with all ABC Subsidiaries and Business Units to collect necessary data and ensure that the data provided is accurate by performing periodic checks
 </li>
 <li>
 Generating analytical reports related to ECL from Strategic System
 </li>
 <li>
 Define and validate the integration of the RCO with other risk management systems
 </li>
 <li>
 Preparing and maintaining all internal standards, policies and rules on IFRS9. Active engagement, awareness and monitoring of any proposed or announced policy changes together with preparation for the impact of such changes
 </li>
 <li>
 Providing support for other critical strategic risk management initiatives which include Risk MI Dashboard, Stress Testing, ICAAP, portfolio reporting etc
 </li>
 <li>
 Maintaining and monitor ECL strategic system configuration for any required changes. Engage and perform any necessary UAT for changes in the RCO and assist with efforts to automate the ECL computation where applicable
 </li>
 <li>
 Reporting P&amp;L Charge to GCC which includes reconciliation between Group Finance &amp; Group Risk. Not limited to reconciliation of Stage 3 accounts with Group RLU
 
 
 
 </li>
 </ul>
 
 Areas Of Knowledge, Qualification And Experience
 
 
 
 <ul>
 <li>
 2-5 years' experience in a similar function with a large regional or global financial institution
 </li>
 <li>
 A graduate degree with Banking &amp; Finance Background
 </li>
 <li>
 High level of data handling skills.
 </li>
 <li>
 Strong knowledge of IFRS9 regulations
 </li>
 <li>
 Good knowledge of Credit Risk measurement techniques such as risk ratings.
 </li>
 <li>
 Strong, hands-on proficiency in SQL and related database technologies ( i.e. SAS, R &amp; Python) beyond basic or high-level understanding.
 </li>
 <li>
 Ability to learn and update skills on the job.
 </li>
 <li>
 Expert-level Excel skills, including data cleaning, advanced functions (e.g., VLOOKUP/XLOOKUP, INDEX-MATCH), and large-dataset management.
 </li>
 <li>
 Good organizational skills
 </li>
 </ul>
</div>

IFRS9 & ECL Reporting Officer - Arab Banking Corporation

Bank ABC

<div>
 
 Bank ABC seeks to recruit an Officer in the Loans &amp; Islamic Operations Department based in our head office, in Bahrain.
 
 
 
 
 
 The Job Officer will be responsible for undertaking designated activities within the department to ensure service standards are achieved and risks managed. Be responsible for carrying out a range of demanding clerical, reconciling, data administration and control / monitoring services and duties, in order to ensure timely delivery of a quality service to clients, other Bank ABC units and departments in line with agreed service standards and within budgets.
 
 
 
 
 
 
 
 Scope of the Job
 
 
 
 
 
 
 
 The job holder will support in:
 
 <ul>
 <li>
 Timely and accurate delivery of all requested projects and initiatives ensuring these are within specification and budgeted costs.
 </li>
 <li>
 Carrying out a range of demanding clerical, data input, reconciliation, data administration and monitoring services, ensuring that the work is completed accurately, on time and in adherence to all specified Bank processes, procedures, standards, SLA, and relevant external regulations.
 </li>
 <li>
 Identifying and suggesting improvements to new and existing processes / procedures / systems and the way in which the team operates to improve service quality and process efficiency.
 </li>
 <li>
 Maintaining up-to-date awareness of market conditions, bank products and services to ensure that best practice is adopted where required.
 </li>
 <li>
 Participating in the evaluation and implementation of new or upgrades to existing IT systems and new products including the performance of robust user testing in accordance with bank standards.
 </li>
 <li>
 Assisting in the preparation of reports and escalating irregularities to management and other regulating units/parties.
 </li>
 <li>
 Providing business support during weekends, bank holidays and other times when the Bank would usually be closed in Bahrain, but markets are open in other parts of the world.
 </li>
 <li>
 Responding to a range of demanding enquiries, clarifying customers and other departments/units understanding of the information being given.
 </li>
 <li>
 Undertaking duties at a similar or higher level as required.
 </li>
 <li>
 Undertaking delivery of designated activities in order to provide an effective service to other departments/units in accordance with agreed service standards.
 </li>
 <li>
 When required, support line management with the implementation of changes in own work area.
 </li>
 </ul>
 
 
 
 
 
 
 Areas of Knowledge, Qualification and Experience
 
 
 
 
 
 
 <ul>
 <li>
 1-2 years of experience in more than one area of the following (Agency, Participation, Islamic Products processing, Supply Chain products and Bilateral Loans Operations).
 </li>
 <li>
 Bachelor&rsquo;s degree or qualification in the following fields Finance, Banking, Accounting, Business or Risk Management.
 </li>
 <li>
 Good understanding of Loans Syndication, Agency, Participation Corporate loans and Islamic products, services, operations, and technology gained from hands on experience in operational roles.
 </li>
 <li>
 Oral Communication: Uses clear, concise and jargon-free speech to explain products/services/procedures and resolve problems. Use effective telephone manners with customers/colleagues.
 </li>
 <li>
 Written Communication: Produces written responses to enquiries using appropriate wording. Produces clear and accurate written material.
 </li>
 <li>
 Self / Work Organization: Knows how to prioritize tasks and diarize effectively to achieve deadlines. When appropriate co-ordinates and allocates tasks, ensuring full and effective use of resources available.
 </li>
 <li>
 Keyboard / Software Applications: Has a thorough understanding of Microsoft Office software including Visio and systems appropriate to the role and can input and extract information to provide a variety of reports.
 </li>
 <li>
 Perceives changes as opportunities to learn and not threats.
 </li>
 <li>
 Sees change from the perspective of the customer.
 </li>
 <li>
 Team Player and Self-motivated who gains and develops skills set to meet challenging requirements.
 </li>
 <li>
 Excellent organizational skills and ability to work under pressure and proactively with minimum supervision.
 </li>
 <li>
 Strong time management and results orientation.
 </li>
 </ul>
 
 
</div>

Officer - Loans & Islamic Operations

<div>
 
 
 Key Responsibilities
 
 /What You Do
 
 
 
 <ul>
 <li>
 Consistently checks, tracks and filing of all claims received.
 </li>
 <li>
 Data entry into company database
 </li>
 <li>
 Validating all received &amp; scanned claims against actualised volumes
 </li>
 <li>
 Perform analytical review of documentation received
 </li>
 <li>
 Ensures that there is a proper documentation, feedback, and endorsement to the concerned unit/department.
 </li>
 <li>
 Timely and precise recording of received claims.
 </li>
 <li>
 Supporting administrative function.
 </li>
 <li>
 Other Ad hoc duties as required.
 
 
 </li>
 </ul>
 
 AI READINESS
 
 Work effectively in an environment shaped by artificial intelligence (AI), machine learning, data analytics and cloud-based tools, using insights responsibly with our standards of data governance, security and ethical use
 
 
 
 Key Requirements/What You Bring
 
 
 
 <ul>
 <li>
 High school diploma or equivalent; Bachelor&rsquo;s degree is advantage
 </li>
 <li>
 1-2 years&rsquo; experience in a customer focused environment, ideally in clinical, paramedical roles or TPA or insurance roles.
 </li>
 <li>
 Proficiency in MS Office
 </li>
 <li>
 A highly customer-focused individual with strong interpersonal, communicative and accuracy skills.
 </li>
 <li>
 Data entry experience would be helpful as it is quite important to be successful for the role
 </li>
 <li>
 Demonstrates excellent attention to detail, accuracy, and the ability to meet strict deadlines
 </li>
 <li>
 Ability to multitask, prioritize and work independently or within a team environment.
 </li>
 <li>
 Organizational skills
 </li>
 <li>
 Team player
 </li>
 <li>
 Physically fit to carry out duties.
 </li>
 <li>
 Ability to demonstrate sounds work ethics.
 </li>
 <li>
 Ability to work under pressure and manage time effectively
 </li>
 <li>
 Legally permitted to work in the country of operations.
 
 
 </li>
 </ul>
 
 How we hire
 
 Allianz Partners does not accept unsolicited CV&rsquo;s or approaches from agencies. We only work with partners on our approved supplier list, under contract. Any unsolicited submission will not be considered.
 
 
 
 Key Benefits/What We Offer
 
 
 
 Allianz Partners is a world leader in B2B2C insurance and assistance, offering global solutions that span international health and life, travel insurance, automotive and assistance. Customer driven, our innovative experts are redefining insurance services by delivering future-ready, high-tech high-touch products and solutions that go beyond traditional insurance.
 
 
 Our products are embedded seamlessly into our partners&rsquo; businesses or sold directly to customers and are available through four commercial brands: Allianz Assistance, Allianz Automotive, Allianz Travel and Allianz Care. Present in 75 countries, our 21,100 employees speak 70 languages, handle over 71 million cases each year, and are motivated to go the extra mile to offer peace of mind to our customers around the world.
 
 
 We at Allianz believe in a strong inclusive culture that encourages people to speak their minds, get involved and question the status quo. We are proud to be an equal opportunity employer and 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.
 
 
 We therefore welcome applications regardless of race, ethnicity or cultural background, age, gender, nationality, religion, social class, disability, sexual orientation, or any other characteristics protected under applicable local laws and regulations.
 
 
 At Allianz Partners, AI is revolutionizing customer service and claims management through innovative solutions. These AI-driven tools enhance productivity by streamlining complex claims processes, reducing administrative burdens, and accelerating resolution times. Our AI-powered technology has made claims processing faster, offering quicker resolutions. All while ensuring human oversight for claims to maintain service integrity. By embracing AI and Emerging Technologies, Allianz Partners continues to lead the industry, meeting ever-changing customer needs with innovative solutions. Our commitment to Ethical AI practices safeguards data integrity and trust, ensuring responsible deployment across all operations. This approach not only enhances customer experiences but also supports strategic initiatives like fraud detection and personalized product offerings, solidifying Allianz Partners' position as a leader in the insurance sector.
 
 
 Great to have you on board. Let's care for tomorrow.
</div>

Claims Administrator

<div>
 The Case Management Utilization Review Lead is responsible for in managing the High-cost cases while ensuring that departmental goals, timeline of activities, and compliance measures are met.
 
 
 
 What You Do
 
 
 
 <ul>
 <li>
 Performing complete file review of high cost claims with regards to the multidisciplinary notes, TPR charts, physician order&rsquo;s notes, lab reports, radiology reports, drug chart sheets, consultation notes, nursing notes, progress notes, etc.
 </li>
 <li>
 Field hospital deployment or File Audit to be performed when required (Non- Physical or Physical [Provider Visit]) to capture hospital acquired infections, mismanagement, iatrogenic injuries, etc.
 </li>
 <li>
 Requesting any medical documentation or finding any missing document which is essential in decision making.
 </li>
 <li>
 Performing review of DRG Severity of Illness (SOI) in line with revision of CPT codes / ICD codes, which are being up-coded by the provider &ndash; if required discussion with the treating doctor and the medical coders.
 </li>
 <li>
 Performing utilization review for DRG cases and FFS cases with regards to and not limited to final bill review + consumables mark ups + non covered item/services + overutilization of services.
 </li>
 <li>
 Performing review of claims as per CPT and ICD coding guidelines in line with insurance regulators (DHA,DOH/HAAD,MOH).
 </li>
 <li>
 Pre-authorization and maintaining required out-put of high cost claims with detailed insight of claim on day to day basis.
 </li>
 <li>
 Adhering to the case management and cost containment protocols for elective high cost cases and medical management cases.
 </li>
 <li>
 Referring cases for second opinion when deemed necessary to confirm the best mode of management &ndash; also for cost containment to lesser Negotiating factor (NF) facilities within the member&rsquo;s network or option for home country treatment.
 </li>
 <li>
 Adjudicates High Cost claims at submission level for settlement between the insurer and health care provider as per policy terms and conditions.
 </li>
 <li>
 Adjudicates High cost claims at precertification level, authorize decision on the claim within policy terms and conditions.
 </li>
 <li>
 Continuously work to identify possible procedure inconsistencies; develop, recommend and implement improvements.
 </li>
 <li>
 Provide support to Medical Claims Officers to close all escalated claims queries within the agreed turn-around time.
 
 
 </li>
 </ul>
 Achieving a monthly savings target of AED 800,000 in line with the criteria or methodology defined by the Line Manager and Head of Department
 
 
 <ul>
 <li>
 AI READINESS Work effectively in an environment shaped by artificial intelligence (AI), machine learning, data, analytics and cloud-based tools, using insights responsibly with our standards of data governance, security and ethical use.
 
 
 </li>
 </ul>
 
 What You Bring
 
 
 
 <ul>
 <li>
 Bachelor&rsquo;s of Medicine (MBBS);
 </li>
 <li>
 3+ years medical practical experience (reputable insurance provider, broker or a TPA experience a plus).
 </li>
 <li>
 Knowledge of overall insurance industry practices is a plus.
 </li>
 <li>
 Legally permitted to work in the country of operations.
 </li>
 <li>
 Physically fit to carry out duties.
 </li>
 <li>
 Fluency in MS Office (Excel, Word, Outlook, PowerPoint) and general internet navigation and research skills.
 
 
 </li>
 </ul>
 
 How We Hire
 
 
 
 
 
 Agency Statement
 
 Allianz Partners does not accept unsolicited CV&rsquo;s or approaches from agencies. We only work with partners on our approved supplier list, under
 
 
 contract. Any unsolicited submission will not be considered
 
 
 
 
 Key Benefits/What We Offer
 
 
 
 Allianz Partners is a world leader in B2B2C insurance and assistance, offering global solutions that span international health and life, travel insurance, automotive and assistance. Customer driven, our innovative experts are redefining insurance services by delivering future-ready, high-tech high-touch products and solutions that go beyond traditional insurance. Our products are embedded seamlessly into our partners&rsquo; businesses or sold directly to customers, and are available through four commercial brands: Allianz Assistance, Allianz Automotive, Allianz Travel and Allianz Care.
 
 
 At Allianz Partners, Artificial Intelligence (AI) is transforming service delivery and innovation. By leveraging Business Intelligence and Data Analytics, we enhance strategic decision-making and customer experiences. Our commitment to Ethical AI ensures responsible deployment, maintaining data integrity and trust. Conversational AI improves communication, while Emerging Technologies and Generative AI drive industry leadership and new opportunities. With robust Information Security Management, we protect sensitive information, ensuring compliance and security. Embrace the future of AI with Allianz Partners, where possibilities become realities.
 
 
 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 to shape a better future for our customers and the world around us.
 
 
 At Allianz, we stand for unity: we believe that a united world is a more prosperous world, and we are dedicated to consistently advocating for equal opportunities for all. And the foundation for this is our inclusive workplace, where people and performance both matter, and nurtures a culture grounded in integrity, fairness, inclusion and trust.
 
 
 We therefore welcome applications regardless of ethnicity or cultural background, age, gender, nationality, religion, social class, disability or sexual orientation, or any other characteristics protected under applicable local laws and regulations.
 
 
 
 Great to have you on board.
 
 Let's care for tomorrow.
 
 
 Note: Having different strengths, experiences, perspectives and approaches is an integral part of Allianz&lsquo; company culture. One means to achieve this is a regular rotation of Allianz Executive employees across functions, Allianz entities and geographies. Therefore, the company expects from its employees a general openness and a high motivation to regularly change positions and collect experiences across Allianz Group.
</div>

Field doctor - Lead role

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