Medical Claims officers Outpatient Pre-certification

Assesses approval of medical approvals as well as policy use.Check particular treatment plan is necessary for the patient.Inputs verbal and written claims approvals regularly.Decide approvals as per policy conditions.Assess high-cost claims and provide decisions on high-cost and complicated cases.Provide clear feedback on queries from call Centre...

Assesses approval of medical approvals as well as policy use.Check particular treatment plan is necessary for the patient.Inputs verbal and written claims approvals regularly.Decide approvals as per policy conditions.Assess high-cost claims and provide decisions on high-cost and complicated cases.Provide clear feedback on queries from call Centre...

**Summary** The Precertification Officer is responsible for obtaining prior authorizations for all procedural orders by successfully completing the authorization process with all commercial payers with high efficiency and within the agreed turnaround time to maintain the team KPIs. **Main Tasks** - Assesses approval of medical approvals as well as policy...

**Summary** The Precertification Officer is responsible for obtaining prior authorizations for all procedural orders by successfully completing the authorization process with all commercial payers with high efficiency and within the agreed turnaround time to maintain the team KPIs. **Main Tasks** - Assesses approval of medical approvals as well as policy...

Your Role: Medical Claims Executive - Evaluate claims (Network & Direct), provide authorizations for insured members (in-patient & outpatient) and handle calls relating to medical cases efficiently. - Managing all the members approval/claims and following up with insurance companies/TPAs to get approval within the TAT. - Assisting our clients for...

SummaryThe Precertification Officer is responsible for obtaining prior authorizations for all procedural orders by successfully completing the authorization process with all commercial payers with high efficiency and within the agreed turnaround time to maintain the team KPIs.Main Tasks Assesses approval of medical approvals as well as policy use. Checks...

**Summary** The Precertification Officer is responsible for obtaining prior authorizations for all procedural orders by successfully completing the authorization process with all commercial payers with high efficiency and within the agreed turnaround time to maintain the team KPIs. **Main Tasks** - Assesses approval of medical approvals as well as policy...

We are immediately hiring Medical Claims Processor for insurance TPA - CPT coding system and agreed tariff. - Communicate any of the diagnostic and treatment data to payers and plan to assist patients in obtaining benefits. - Facilitate analysis of an insured member to improve care, delivery, and efficiency of operations to contain costs. - Accurately post...

We are immediately hiring a Medical Claims Officer for our TPA Almadallah Healthcare Must have 5+ years experience in Medical Insurance/TPA experience as a Medical Claims Officer Qualification-MBBS (mandatory) Salary-8000-9000 AED/month Preference for immediate joiners Pay: AED9,000.00 - AED10,000.00 per month **Experience**: - TPA/Insurance: 1 year...

We are immediately hiring a Medical Claims Officer for our TPA Almadallah Healthcare Must have 5+ years experience in Medical Insurance/TPA experience as a Medical Claims Officer Qualification-MBBS (mandatory) Salary-8000-9000 AED/month Preference for immediate joiners Pay: AED8,000.00 - AED9,000.00 per month Application Question(s): - Do you have...

Examine claims records and forms to determine whether the patient has medical insurance. - Review provisions of certificate or policy to determine the patient’s included medical coverage losses. - Negotiate claim settlements and make recommendations for legal action when settlements are deemed non-negotiable. - Complete logs, reports, forms and records to...

Resolves medical claims by approving or denying documentation; calculating benefit due; initiating payment or composing denial letter. - Establishes proof of loss by checking medical documentation; assembling additional information as required from outside sources, including claimant, physician, employer, hospital, and other insurance companies; initiating...

Minimum 3+ years experience in a similar role. - Bachelor’s Degree in any stream - Specialist in the area of claim resubmissions & reconciliations. - Medical Coding Certificate; RHIT or CPC by AAPC or AHIMA Certificate - Fluency in English (speak, read and write). Arabic speaking skills will be an added advantage. - Computer Literacy skills are required. -...

**Job Family Summary**: The Operations Department is responsible to manage all aspects of claims management including Onsite operations and back end processing. The department primarily works on main objective of submitting the claims in time with highest quality to ensure the client receives the payment with mínimal or no rejections. **Role...

The Medical Claims - Team Lead will provide quality service to clients by promptly and effectively assessing and processing claims and approval according to operations set standards. Team Leader will evaluate complicated pre-authorization claims, medical evaluations, direct claims coverage, errors, and claims turn-around time and process queries to achieve...

**Job Designation **:Medical Claims Supervisor **Job Location** : NGI- Head Office **Responsibilities** - Responsible for the screening of claims to ensure cost containment, medical necessity, and check for fraudulent activity. - Screen all claims (e-claims and paper claims) in a proper and aggressive manner for all hospitals, clinics, and pharmacies for...

**What we do** **What you bring** - Prepare concise documentation and audit reports, including recommendations to claims management for improvements with corrective action plans; - Audit, assess, and monitor providers and payers, to include but not limited to physicians, inpatient, outpatient, ancillary, behavioral healthcare, laboratory, etc. medical...

Our company Commercial Insurance Brokerage Services is looking to hire a Medical Claims Officer to join our technical team in Dubai. Reporting to the General Manger the incumbent will be responsible for the entire medical underwriting process through a variety of technical tasks. **Responsibilities** - Evaluates and processes claims in accordance with...

**Summary** The Claims officer provides quality service to clients, promptly and effectively assesses and process claims and approval according to operations set standards. **Main Tasks** - Evaluates medical claims from the technical and medical perspectives as per policy terms and conditions. - Checks particular treatment plan is necessary for the...

**Summary** The Claims officer provides quality service to clients, promptly and effectively assesses and process claims and approval according to operations set standards. **Main Tasks** - Evaluates medical claims from the technical and medical perspectives as per policy terms and conditions. - Checks particular treatment plan is necessary for the...