Claims Retrospective Associate

🏢 NEXTCARE
📍 EgyptFull-timeOn-site
📅 Posted: Today🔄 Updated: Today
CV%
✨ AI Summary
The Claims Retrospective Associate will be responsible for assessing and processing IP and OP claims according to operational standards, ensuring quality service to clients. Key responsibilities include assessing medical approvals, guiding Medical Claims Officers, monitoring daily output and error reduction, providing second opinions on treatment plans, assessing high-cost claims, and communicating claim decisions to clients. The role also involves managing routine claims administration, coordinating workflow, meeting deadlines, and providing on-the-job training. Candidates should be comfortable working in an AI-shaped environment and utilizing data responsibly.
Required Skills
Productivity & Workplace Tools
WordPowerPoint
Other
Certified Medical CoderMedical Practical ExperienceInternet navigation
Soft Skills & Professional Competencies
Research
🎁 Benefits & Perks
Allianz Partners offers competitive benefits as a world leader in B2B2C insurance and assistance, focusing on global solutions and innovative, high-tech, high-touch products. They foster an inclusive workplace that values integrity, fairness, inclusion, and trust, providing equal opportunities and caring for employees' ambitions, dreams, and challenges.
Requirements
Bachelor's of Pharmacy, Dentistry, or Medicine. Medical practical experience in a reputable insurance provider, broker, or TPA is a plus, or entry-level. Must be physically fit, legally permitted to work in the country, and proficient in MS Office and general internet navigation and research skills. AI readiness is important.
Description
Job OverviewThe Claims Retrospective Associate will provide quality service to clients, promptly and effectively assesses and process IP and or OP claims according to operations set standards.Key Responsibilities/What You Do Assesses approval of medical approvals as well as policy use Channels Medical Claims officers in handling difficult medical cases and optimize the quality and quantity output. Monitors daily output on the number of case done and decrease in number of errors committed. Provides second opinion for cases where there is doubt in treatment plan. Assess high cost claims and provide decision on high cost and complicated cases. Provides clear feedback on queries from call Centre team. Provides clients an understanding of any declined medical claims. Manages routine daily claims administration work. Coordinates work flow & meet deadlines. Provides on job training to team members as necessary.AI READINESS Work effectively in an environment shaped by artificialintelligence (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 BringBachelor's of Pharmacy / Dentistry / Medicine.Medical Practical Experience (reputable insurance provider, broker or a TPA experience a plus) OR Entry LevelPhysically fit to carry out duties.Certified Medical Coder [Preferable]Legally permitted to work in the country of operations.Fluency in MS Office (Excel, Word, Outlook, PowerPoint) and general internet navigation and research skillsHow We HireAllianz Partners does not accept unsolicited CV'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 OfferAllianz 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.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.Join us. Let's care for tomorrow.
✨ Premium Match Details
Deep-dive CV analysis, customized Cover Letters, and Interview prep!
📊 Match Analysis
Insights against your active CV
📊
Personalized Match Analysis
Upload your CV to see exact matching percentages, detailed skills mapping, and gap analysis for this role.
🎯 Overalli74%
⚡ Skillsi85%
View Breakdown
Ontology Match: 85.0
Matched:✓ Requirements Matching✓ Ontology Skills Mapping
📜 Eligibilityi49%
View Breakdown
Local: 19600%
🏗️ Career Fiti91%
View Breakdown
Seniority: 91.0
📋 Requirementsi67%
View Breakdown
Domain: 67.0
🔥 Motivationi78%
View Breakdown
Title Fit: 78.00