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Job overview

The role of claims officer involves processing medical claims for clients worldwide. We provide a high level of client service while processing claims within an industry-leading 48 hours.

The claims officer also adjudicates medical providers’ claims, ensuring that services are eligible under policy terms and conditions, correspond with the authorized guarantee of payment, and are paid according to agreed provider tariffs.

The claims department is a fast-paced and challenging environment, with many languages spoken and a mixture of cultures.

What you do

Responsibilities will include, but are not limited to, the following:

• Adjudicate and process claims within the agreed company service-level agreement (SLA), clearing the queue to zero in accordance with policy benefits and helping the company achieve its loss ratio target.
• Use the client database accurately and effectively to ensure reports reflect the department’s workload and support effective target planning.
• Meet company service standards and clear the queue to zero to support customer satisfaction and retention.
• Contribute to team and departmental productivity targets to help achieve the agreed SLA and provide a high level of customer service.
• Identify duplicate payments, overbilling, upcoding, possible nondisclosure, and fraudulent claims in line with the company’s cost-containment policy.
• Respond to customer enquiries accurately and professionally, liaising with other departments for support when necessary to provide an efficient response and achieve customer satisfaction.
• Participate in departmental medical training to expand knowledge of medical terminology and procedures and develop comprehensive claims-processing skills.
• Take on additional tasks to support the team leader in delivering team key performance indicators (KPIs), and deputize for the team leader as needed.
• Provide support and guidance on escalated issues, complaints, and challenging claims, and lead by example.
• Adapt to a variety of claims-handling tasks and support a multitasking role.
• Meet high-quality standards in work performance at all times.
• Support the team leader in driving team engagement.
• Assist the in-house medical team by using artificial intelligence (AI) models to streamline client hospital admissions, evacuations, repatriations, and other cases, ensuring efficient and effective service.
• Use AI to automate routine tasks, speed up adjudication, and process claims efficiently, helping achieve the loss ratio target.
• Use AI analytics to enhance the client database, provide deeper insights, and generate more accurate reports to support better target planning.
• Work effectively in an environment shaped by AI, machine learning, data, analytics, and cloud-based tools. Use insights responsibly and follow standards for data governance, security, and ethical use.

At Allianz Partners, AI is transforming service delivery and innovation. Business intelligence and data analytics enhance strategic decision-making and customer experiences. Our commitment to ethical AI supports responsible deployment, data integrity, and trust. Conversational AI improves communication, while emerging technologies and generative AI create new opportunities. Robust information security management helps protect sensitive information and maintain compliance. Embrace the future of AI with Allianz Partners, where possibilities become realities.

What you bring

Key requirements:

• One to two years of experience in a customer-focused environment, ideally in clinical or paramedical roles, or in third-party administration (TPA) or insurance.
• Proficiency in Microsoft Office.
• Completion of, or progress toward, the Diploma in Private Medical Insurance.
• A strong customer focus, with excellent interpersonal and communication skills and a high level of accuracy.
• A team-oriented approach.
• Physical fitness to carry out the duties.
• A sound work ethic.
• The ability to work under pressure and meet tight deadlines and service standards.

How we hire

Agency statement: Allianz Partners does not accept unsolicited CVs or approaches from agencies. We work only with partners on our approved supplier list under contract. Unsolicited submissions will not be considered.

What we offer

Allianz Partners is a world leader in business-to-business-to-consumer (B2B2C) insurance and assistance, offering global solutions across international health and life, travel insurance, automotive, and assistance. Customer-driven, our innovative experts are redefining insurance services with future-ready, high-tech, high-touch products and solutions that go beyond traditional insurance. Our products are seamlessly embedded in 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 world’s most trusted insurance and asset management companies. Caring for our employees, their ambitions, dreams, and challenges makes us a unique employer. Together, we can build an environment where everyone feels empowered and confident to explore, grow, and shape a better future for our customers and the world around us.

At Allianz, we stand for unity. We believe a united world is a more prosperous world, and we are dedicated to consistently advocating for equal opportunities for all. Our inclusive workplace is the foundation for this commitment, nurturing a culture grounded in integrity, fairness, inclusion, and trust, where people and performance both matter.

We welcome applications regardless of ethnicity or cultural background, age, gender, nationality, religion, social class, disability, sexual orientation, or any other characteristic protected under applicable local laws and regulations.

Great to have you on board. Let’s care for tomorrow.

Note: Different strengths, experiences, perspectives, and approaches are integral to Allianz’s company culture. One way we support this is through regular rotation of Allianz executive employees across functions, entities, and geographies. Employees are therefore expected to be open to and motivated by regularly changing positions and gaining experience across Allianz Group.