Claims Investigation Executive
1 month ago
Process health claims, identify potential abuses, and ensure strategic initiatives align with company goals, focusing on risk mitigation and fraud prevention.
Key Responsibilities:
- Process and assess health claims, particularly in investigation cases.
- Identify and flag potential abuses or suspected fraud during claim assessments.
- Assess health claims for potential non-disclosures or pre-existing conditions, and develop strategies to gather evidence.
- Meet targets for cost avoidance.
- Review and resolve outstanding investigation claims.
- Liaise with customers, agents, and doctors to facilitate claim settlements.
- Ensure claims are processed within the department's specified turnaround time.
- Draft and send correspondence independently.
Requirements for Success:
- Graduate in bio-medical science or related field (advantageous).
- 2 years of experience in health claims (advantageous).
- Knowledge of medical terms/medical related studies (advantageous).
- Experience in claims investigation.
- Good communication skills in both written and verbal.
- Ability to think creatively.
Allianz Group is a leading insurance and asset management company, committed to caring for its employees and customers. We strive to create an inclusive and diverse work environment where everyone feels empowered to grow and contribute.
We welcome individuals from diverse backgrounds and perspectives, and are proud to be an equal opportunity employer.
We are committed to building a better future for our customers and the world around us.
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