Provider Claims Manager

Titles

Requirements

Job Description

Claims Manager

• Bachelor’s degree in any Medical field, Finance, Business Administration, Insurance, or a related field preferred.
• Leading a large multicultural team based in Dublin and working closely our Global offices to active the required departmental KPIs in line with orgnisation goals .
• Minimum of 8 years of experience in claims management or a related field, with at least 4 years in a leading role.
• Act as a liaison between the Global Management and the claims team, ensuring clear communication and alignment of objectives.
• Proven track record of effectively managing teams and achieving operational goals.
• Development and implementation of departmental strategies and goals.
• Strong leadership and team management skills.
• Provide regular updates and reports to the Regional Management on team performance, claims processing, and customer satisfaction.
• Excellent communication, negotiation, and interpersonal skills.
• Participate in strategic planning with clear decision-making processes.
• Analytical mind-set with the ability to interpret complex data and make data-driven decisions.
• Promote high performance culture and provide guidance, training, and mentorship to team members to enhance their skills and performance.
• Proficiency in claims management software and Microsoft Office Suite.
• Monitor team workload and ensure equitable distribution of tasks.
• Detail-oriented with strong organizational and time management skills.
• Review complex or escalated claims and provide guidance on claim determinations.
• Ability to work in a fast-paced environment and manage multiple priorities effectively.
• Resolve escalated customer inquiries and complaints regarding claims issues.
• Flexibility to adapt to changing business needs and work under pressure.
• Analyse claims data and performance metrics to identify trends and opportunities for process improvement.
• Legally permitted to work in the country of operations.
• Prepare and present reports on claims activities, outcomes, and key performance indicators (KPIs) to senior management.

• Utilize data analysis to drive strategic decision-making and optimize claims processes.

• Actively participate in various operational activities, outside of claims, to ensure that operational service delivery is coordinated to meet and exceed clients’ expectations.

• Assist in Developing and updating claims policies and procedures.

• Ensure team adherence to all regulatory and company guidelines.

• Prepare and present regular reports on claims activity, performance metrics, and trends.

• Analyse data to identify areas for improvement and implement corrective actions.

• Other Ad hoc duties as required.

67163 | Operations | Professional | Non-Executive | Allianz Partners | Full-Time | Permanent

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