Agent

• Audit and process all types of providers’ bills
• Examine claim documents thoroughly
• Apply correct pricing before processing bills in TATSH
• Handle claim adjustments
• Use AI-based screening tools to verify accurate insurance claim entry and timely payment
• Verify required TATSH fields, including visa notes, precertification center notes, contract notes, policy files, medical files, and faxes
• Process and record invoice details according to policy terms, product type, TOB, and information from medical auditors, providers, and precertification officers
• Follow up daily on pending claims or issues with relevant departments until resolved
• Notify the Network department about jumbo claims to secure special provider discounts
• Report provider deviations from agreed tariffs to the Network department
• Report payer or provider invoice complaints to the Team Leader or Manager
• Communicate requests or required information from other departments to the Team Leader or Manager
• Adhere to departmental internal procedures
• Maintain confidentiality and properly manage insured member data, system information, policies, and medical records
• Perform other duties assigned by the Direct Manager
• Work effectively with AI, machine learning, data, analytics, and cloud-based tools while following data governance, security, and ethical-use standards

Explore Claims Processing Agent at Allianz. Review requirements and application details.