The Claims Operations Manager will manage Healthcare providers claims and ensure our Claims Operations team to meet required department KPI’s including timelines, cost, customer service and scope accuracy. The key focus of the team is Performance, Relationship between the clients and Allianz Partners
Key responsibilities/What you do:
Leading a team of claims adjusters to active the required departmental KPIs in line with orgnisation goals .
Act as a liaison between the Global Management and the claims team, ensuring clear communication and alignment of objectives.
Development and implementation of departmental strategies and goals.
Provide regular updates and reports to the Regional Management on team performance, claims processing, and customer satisfaction.
Participate in strategic planning with clear decision-making processes.
Provide guidance, training, and mentorship to team members to enhance their skills and performance.
Monitor team workload and ensure equitable distribution of tasks.
Review complex or escalated claims and provide guidance on claim determinations.
Resolve escalated customer inquiries and complaints regarding claims issues.
Analyse claims data and performance metrics to identify trends and opportunities for process improvement.
Prepare and present reports on claims activities, outcomes, and key performance indicators (KPIs) to senior management.
Utilize data analysis to drive strategic decision-making and optimize claims processes.
Actively participate in various operational activities, outside of claims, to ensure that operational service delivery is coordinated to meet and exceed clients’ expectations.
Assist in Developing and updating claims policies and procedures.
Ensure team adherence to all regulatory and company guidelines.
Prepare and present regular reports on claims activity, performance metrics, and trends.
Analyse data to identify areas for improvement and implement corrective actions.
Other Ad hoc duties as require
Key Requirements/What You Bring
Bachelor’s degree in any Medical field, Finance, Business Administration, Insurance, or a related field preferred.
Minimum of 8 years of experience in claims management or a related field, with at least 4 years in a leading role.
Proven track record of effectively managing teams and achieving operational goals.
Strong leadership and team management skills.
Excellent communication, negotiation, and interpersonal skills.
Analytical mind-set with the ability to interpret complex data and make data-driven decisions.
Proficiency in claims management software and Microsoft Office Suite.
Detail-oriented with strong organizational and time management skills.
Ability to work in a fast-paced environment and manage multiple priorities effectively.
Flexibility to adapt to changing business needs and work under pressure.
Legally permitted to work in the country of operations.
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.
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.
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’ 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.As part of the Allianz Group, we are proud to be the Worldwide Insurance Partner of the Olympic and Paralympic Movements.For more information, please visit: www.allianz-partners.com
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