Finance Reconciliation Process Lead

We are Allianz Partners. The leader in assistance and insurance solutions in the areas of international health, assistance, automotive and travel insurance. Allianz Partners is a global family of over 19,000 employees across 78 countries. This role is in the International Health part of the business, which has a number of well-known customer facing brands such as Allianz Care, Nextcare and Medi24.

The International Health line of business provides international health, life and disability insurance and services, reinsurance and administration services to a wide range of customers. These include multinational companies, intergovernmental organisations (IGOs), non-governmental organisations (NGOs), private individuals, families and students. Our mission is to ensure that customers have access to quality healthcare through our support, care and commitment to go the extra mile. We are a truly global health partner for our customers, ensuring fast and simple access to the best advice, treatment and value for our customer.

Job Description/ What You Do

• Collection of the Direct Billing claims OS ( Tracking the released reference to the payers and claiming the due payment each per as per its due date )
• Collection of the Reimbursement - To be paid - On site doctors claims OS ( Tracking the released reference to the payers and claiming the due payment each per as per its due date )
• Tracking the down payment of the Reimbursement claims ( Some payers paying a down payment to cover their reimbursement claims ) , So I have to track their consumption and claiming them to refill again the balance by the same amount of the down payment)
• Reconciling the received payment ( Transfer / Cheques ) by showing what does the received payment were related to and update the Finance Team in order to release the payment to the providers.
• Provide the OPS with the rejected amounts to investigate on it ( The received payment mentioned above may be received included a rejection So we have to update the OPS with the rejected amount to investigate it on a medically wise and update us with the latest status of the rejected amounts.
• Deletion ( Deleted members ) those are the patients that has been resigned from their companies and still having the medical card. May be someone use the medical card for a service doesn’t need a pre-approval , So in that case the payer should pay this amount separately. So we should follow up the OS of the deletion
• PO Work Flow ( there is an excel sheet named by PO Work flow it is including all released payment orders so we have to update all paid or rejected payment orders on the excel to know which paid which rejected.
• Financial claim record ( Update all the received payment on the FC by recording the received amount and the date
• Matching ( Release all references from the system and compare it with the released invoices from our side to know if there is something missed not yet released.
• Provision ( We do that report in quarterly basis which is clarifying the status of the rejected and the refunded amounts ) In order to support us in making the needed action plan for the work.for the work.
• Tracking Consumption / Down payment ( Some payers paying a down payment to cover their consumption so we have to make track their consumption according to the D.P
• Annual reconciliation for the payers and policies ( Reconcile the statement with the payer if a spacific policy or all policies has been finished ) we doing a reconciliation by calculate the consumption and the payment ).
• Following up the OPS until correcting the liabilities of the rejected amounts from the payers ( As mentioned that may the received payment has a deducted amount due to many reasons our responsibility is to following up the OPS until investigating on the rejected reason until reconcile the rejected amounts to be on the provider liability if it’s his fault or NC liability if it our fault).
• Tracking the Selfunded policies ( As the same as tracking the consumption VS the down payment ).
• Tracking the non delivered claims ( A report we are release it from TATSH to show if there any claims have been finished and not released to the payers or not and invistigate if any, as its effect on the collection and cash flow)
• Tracking the OS on daily basis due to the new payment cycle to our providers which requires accelerating the collection of the claims from its payers
• managing the provider reconciliation section
  
  

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51969 | Underwriting | Professional | Non-Executive | Allianz Partners | Full-Time | Permanent

Key Requirements/ What You Bring

• Strong negotiation, communication, attention to detail.
• Ability to work independently and maintain focus under pressure.
• Ability to work well as part of a team- to exhibit objectivity and be open-minded towards the ideas and views of others, give as well as welcome feedback, contribute to building team spirit, aid others to succeed.
• Ability to comprehend, capture as well as interpret basic customer information others besides upholding the values of the organization.
• Ability to manage difficult customer situations, to respond promptly to the needs of the customer, solicit feedback to improve service, responds to request for service/assistance.
• Ability to adapt to change, meet the changing demands of the work environment, any delays or other unexpected demands.
• Ability to treat people with respect under all circumstances, instill trust in others besides upholding the values of the organization.
• Proven time management skills.