Treatment Guarantee And Pre-Certification Officer

As an International Health Insurance Consultant – Treatment Guarantee and Pre-Certification Officer, your key responsibilities will include:

• Reviewing and assessing health insurance claims for international healthcare services, ensuring compliance with policy terms, conditions, and regulatory requirements.
• Analyzing medical reports, invoices, and supporting documents to determine claim eligibility and coverage levels.
• Processing and adjudicating claims with accuracy and efficiency, adhering to established procedures.
• Communicating with insured individuals, medical providers, and stakeholders to gather additional information or clarifications, ensuring timely and accurate resolution.
• Issuing Treatment Guarantee Documents to Providers and Insured Persons as per the guidelines established for Treatment Guarantee
• Managing complex claims, including those related to chronic illnesses, pre-existing conditions, and high-cost treatments, ensuring fair and equitable handling in line with policy guidelines and industry best practices.
  
  

• Strong ability to plan, prioritize, and organize tasks while managing competing resources and demands.
• Team player with a willingness to support a collaborative and supportive culture.
• Excellent verbal and written communication skills, with the ability to balance empathy and compassion with achieving the best commercial outcomes for Allianz Partners.
• Ability to deliver superior customer service to a range of internal and external stakeholders.
• Proficiency in multitasking and working in a fast-paced environment.
• High attention to detail and pride in work accuracy.
• Confidence in learning, accessing, and utilizing various systems and software applications.
• Empowered decision-making skills.
• Technical experience in thoroughly investigating and interpreting claims and refund outcomes to communicate effectively with customers.
• Experience in the financial or insurance sector is a plus.
• Strong problem-solving and analytical skills.
• Effective time management and multitasking abilities.
• Positive and flexible team player, contributing to a dynamic customer service team.
• Ability to self-manage performance against business requirements.
• Commitment to personal development and continuous learning
  
  

• Deliver exceptional customer service by promptly addressing inquiries and resolving issues related to claims, policy coverage, and reimbursements.
• Keep up-to-date with industry trends, regulatory changes, and best practices in claims management and international healthcare to ensure compliance with relevant laws and regulations.
• Contribute to the continuous improvement of claims processes, systems, and workflows by providing feedback, identifying enhancement opportunities, and actively participating in improvement initiatives.
• Maintain accurate records and documentation of claims, ensuring confidentiality and data privacy in line with company policies and regulatory requirements.
• Work collaboratively with cross-functional teams, including customer service, sales, and finance, to ensure a seamless claims experience and efficient settlement for insured individuals.
• Engage in training and development programs to enhance knowledge of international health insurance, claims management, and industry practices.
• Adhere to quality standards, service level agreements, and performance metrics, consistently meeting or exceeding targets for claim accuracy, turnaround time, and customer satisfaction.
  
  

• Bachelor’s degree in any field
• Experience in any Financial / Insurance related field is a plus
• Strong attention to detail, proven problem solving and analytical skills
• Ability to multitask and manage time effectively
• Positive and flexible team player, willing to contribute to a dynamic customer service team
• Ability to self-manage performance against business requirements
• Commitment to personal development and ongoing learning
• Capable to work onsite for first 6 months; hybrid after
• Amenable to follow client specific schedule and holiday
• Open to Adhoc tasks