Job description / Role Job Type
Full Time Job Location
Cairo, Egypt Nationality
Any Nationality Salary
Not Specified Gender
Not Specified Arabic Fluency
Not Specified Job Function
Accounting & Audit Company Industry
Insurance The claims processing officer

The claims processing officer evaluates and audits providers' bills and processes them on the system. He/she performs scans for detection of missing documents and ensures that medical reports, prescriptions/tests/invoices are coherent.

What you do 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 adjustments. 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 to ensure accurate processing such as visa notes, precertification center 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 information as relayed by the medical auditor and provider and/or other relevant details as gathered by the precertification officer. Daily follow-up on pending claims/issues with concerned departments until problem resolution. Meet goals set forth by the company. Inform the network department when receiving a jumbo claim as per agreed procedure in order 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 or tasks required from other departments. Follow and apply the internal procedures of the department. Be 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. Education and experience Baccalaureate degree or equivalent. 2+ years experience within the health care industry (TPAs, insurance companies, hospitals, medical centers). Skills and abilities Demonstrate commitment to producing output based results. Ability to respect deadlines. Excellent team player. Excellent communication and organizing skills. Flexible and able to work shifts. Willing to work overtime when requested. Basic knowledge of MS Office applications. What we offer

Our employees play an integral part of our success as a business. We appreciate that each of our employees is unique and has unique needs and ambitions. We enjoy being part of their journey. We are here to empower you and your professional and personal goals. For that reason, here are some of our benefits:

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 and health insurance. Open company culture, flexibility of working hours, giving you a hybrid working environment. Modern offices.

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, grow, and shape a better future for our customers and the world around us.

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.

We therefore welcome applications regardless of ethnicity or cultural background, age, gender, nationality, religion, disability, or sexual orientation.

Join us. Let's care for tomorrow.

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!

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