Precertification Officer – Medical Claims

About the role

The Precertification Officer ensures prior authorisations for procedural orders are obtained efficiently, meeting turnaround‑time targets and supporting the team’s KPIs.

Key responsibilities

• Assess medical approvals and policy compliance for treatment plans.
• Enter verbal and written claim approvals and decide on approvals per policy conditions.
• Evaluate high‑cost and complex claims, providing decisions in line with guidelines.
• Provide clear feedback to the call‑centre team and explain declined claims to clients.
• Maintain productivity targets: 85% of cases processed within 10 minutes, 98% within the first hour.
• Adjudicate outpatient pre‑certifications on a FIFO basis and meet daily productivity quotas.

Required profile

• Bachelor of Science degree.
• Minimum 2 years of medical‑related experience, preferably with an insurance provider, broker or TPA.
• Fluency in MS Office (Excel, Word, Outlook, PowerPoint) and strong internet research skills.

Required skills

• Excel
• Word
• Outlook
• PowerPoint

What we offer

• Allianz Partners is a global leader in B2B2C insurance and assistance, covering health, life, travel, automotive and assistance solutions.
• The company leverages AI, data analytics and emerging technologies to deliver innovative, high‑tech, high‑touch products and services.