Specialist - AZAY Claim Hospital Fax

About the Role

Assigned to support the Claims Hospital Fax Team. Handle fax claims received from hospitals, track and monitor cases to prevent pending items or backlog.

Responsibilities

• Handle hospital fax claims: check information from fax documents and record into the system.
• Support investigation and decision-making for claims in the system, including approving payments based on authorization, rejecting claims, requesting additional information, issuing memos for administration, submitting for further investigation, and requesting hospital records.
• Monitor and manage pending or backlog cases for Hospital Fax Claims.
• Handle OPD cashless claims from hospitals: investigate and decide (approve, reject, request information, issue memo, submit for investigation, request records) and continuously monitor pending OPD cashless cases or backlog.
• Manage complex cases requiring Claim Committee decisions and present cases to the Claim Committee and COO/CEO according to authorization levels.
• Support claim reimbursement processes.

Qualifications

• Bachelor's or Master's degree in Business Administration, Nursing, Medical Technology, or related field.
• At least 2 years' experience as a nurse, claims assessor, or in related roles within the insurance industry.
• Familiarity with AI tools (e.g., ChatGPT, CoPilot 365) is an advantage.

About the Company

Allianz Group is one of the most trusted insurance and asset management companies in the world. The company is committed to putting customers first and creating an inclusive workplace where integrity, fairness, inclusion and trust are central. Allianz welcomes applications regardless of ethnicity, age, gender, nationality, religion, social class, disability, sexual orientation, or other characteristics protected under local laws and regulations.

Additional Information

• Work arrangement: Onsite.
• Employment type: Full-time.