Sr. Specialist - Pre-Arrangement & Admission (Health Insurance) (Bangkok, TH, 10330)

Allianz
Bangkok
Workplace: HybridFull timeFunction: Insurance & ActuarialExperience: 3+ yearsEducation: bachelorsSkills: ["Communication","Interpersonal skills","Problem-solving"]

Senior nursing professional responsible for pre-authorization and admission processes in health insurance, ensuring medical necessity, cost containment, and adherence to Thai Medical Practice Guidelines. Collaborates with medical consultants, care teams, and providers to assess claims, determine coverage, and issue confirmations within SLA.

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FursaFursa
Allianz
Allianz
2 months ago

Sr. Specialist - Pre-Arrangement & Admission (Health Insurance) (Bangkok, TH, 10330)

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Source: Company careers pageValidated by: Fursa AI
Last checked: 19 hours agoStatus: Live

Job Summary

Senior nursing professional responsible for pre-authorization and admission processes in health insurance, ensuring medical necessity, cost containment, and adherence to Thai Medical Practice Guidelines. Collaborates with medical consultants, care teams, and providers to assess claims, determine coverage, and issue confirmations within SLA.
Location: Bangkok
Workplace: Hybrid
Employment Type: Full time
Job Function: Insurance & Actuarial
Seniority: Sr. Manager level

Key Responsibilities

  • •Review claims and medical reports to verify eligibility of the claim using medical knowledge for pre-arrangement cases.
  • •Consult medical consultant team when medical necessity issues arise.
  • •Apply medical necessity guidelines and determine coverage while implementing cost containment measures.
  • •Coordinate with internal teams (corporate key accounts, care coordinator, medical team) and external providers to share criteria and benchmark price/LOS.
  • •Issue the confirmation letter to providers within SLA (3 days) and ensure cost-effectiveness and safe adoption of new procedures/technologies.

Key Requirements

  • •Bachelor's degree in Nurse Science or related field
  • •Minimum 3 years in nursing experience
  • •Nurse in critical units such as ER, ICU, OR will be an advantage
  • •Knowledge of claims management
  • •Experience in insurance topics: health
Experience:3+ yearsHealthcareHealth insuranceInsurance
Education:Bachelor's
Skills:CommunicationInterpersonal skillsProblem-solving

Company Brief

Allianz
Global insurance and financial services group offering property-casualty insurance, life and health insurance, asset management, and corporate risk solutions to individuals, businesses, and institutions across more than 70 countries.
Industry: Insurance
Company Size: Enterprise (1,001+ employees)
Revenue: USD 1B+
Growth: Public Company
Valuation: Public Company (Market Cap in USD)
Funding: IPO / Publicly Listed
Headquarters: Munich, Germany
Founded: 1890
WebsiteLinkedIn