Medical Officer

Found in: Talent AE 2A C2 - 2 weeks ago


Dubai, United Arab Emirates TPA Full time
RESPONSIBILITIES AND DUTIESResearch and follow up on Medical Treatment patterns and conduct utilization reviews for Beneficiaries (Policyholders) & Medical Network providers, Quality control by:§ Being available (On call) 24 hours a day for Claim Centre Officers queries relating to in-patient claims.§ Assess day-care and in-patient cases as per medical justification and policy coverage.§ Issuing day-care and in-patient cases within AED 15,000.00 for medically justified cases in line with the policy.§ Escalate and confirm grey-area cases. Confirming of exclusions of borderline cases OP/IP.§ Assists CC officers and supervisors in claims adjudication cases as needed.§ Sending request of confirmation and notification to corresponding payers as needed.§ Responding to payer's queries in relation to day-care and In-patient cases.§ Responding to the payers request for advice on coverage of cases.§ Monitor Claims cost as per internal guidelines.§ Rejecting medically unjustified and policy wise excluded day-care and in-patient cases to be signed by Chief Medical Officer.§ Conformity of assessment for the prescribed tests/medications/investigations/clinical procedures§ Issuing day-care and In-patient cases Reimbursement Approval in line with medical and policy coverage.§ Contacting provider for queries and clarifications.§ Doing clinical discussion directly with the network's doctor as needed.§ Seeking verbal clinical opinion from Network's doctor as needed.§ Document and report to CC Supervisor, Assistant Manager and Manager any suspected fraud cases.§ Monitoring and maintaining the claims processing and adjudicating cycle in operational software system as per the defined terms and policy of the organization.§ Establishing strategies and implementing effective parameters for solving all possible queries within the team.§ Taking a lead role in assuring that the assigned tasks to the team are completed within the allocated time frame.§ Ensures the proper communication and implementation of new formats, training and processing rules.§ Entering and processing/ adjudicating claims in operational software system as per the terms and policy of the organization.§ Taking initiatives to maximize team efficiency.§ Maintaining both qualitative and quantitative claims measures.§ Achieving required processing targets assigned by the team-leader on daily, weekly and monthly basis.§ Monitor the qualitative and quantitative measures for IP-claims & pre-approvals.§ Ensure compliance to any changes in terms of system parameters or process.§ Assisting the CC Supervisors / Asst. Manager and Managers as needed.§ Any additional duties commensurate with your position as may be assigned to you from time to time by the Company.3. KNOWLEDGE, SKILLS AND EXPERIENCE§ Medical Doctor (MBBS degree/ MD degree)§ 2 - 3 years’ experience in the healthcare industry/hospitals is mandatory§ Basic Industry knowledge (healthcare/insurance) is a plus.§ Should be a team-player with an aptitude for customer service§ Must be service oriented§ Highly decisive with outstanding logic and reasoning skills§ Excellent oral and written communication skills§ Must be computer literate§ Excellent command of the English language, Arabic is a plus§ Candidate must be tactful and discrete when dealing with clients and must be able to handle confidential information§ Ability to work under pressure and meet tight deadlines and varying work-schedulesJob Types: Full-time, PermanentPay: AED9,000.00 - AED10,000.00 per monthEducation:

Bachelor's (Preferred)

Experience:

Hospital: 2 years (Preferred)Medical Insurance: 1 year (Preferred)

#J-18808-Ljbffr

  • Dubai, United Arab Emirates Ziqitza Gulf Medical Full time

    Job Summary We are looking for a highly capable medical transcriptionist to transcribe voice recordings of medical consultations and procedures. In this role, you will be responsible for transcribing audio files, editing speech recognition transcripts, and formatting transcription reports. You may also be required to enter medical reports into electronic...

  • Medical Liaison

    3 days ago


    Dubai, United Arab Emirates Zahrawi Medical Full time

    **About Zahrawi Group**: Zahrawi Group is a leading company in the GCC Healthcare Industry with its presence in UAE, KSA, Qatar, Bahrain, & Oman markets. The company supplies and distributes high-quality products and services to Hospitals, Clinics, Laboratories, & Analytical Industries. **job Brief**: The incumbent is responsible for driving the demand for...


  • Dubai, United Arab Emirates Padra Medical Center Full time

    **Job brief** We are looking for a Medical administrative assistant to organize our medical facility’s functions. You will support day-to-day operations by performing administrative tasks and ensuring high quality customer service for our patients. As a Medical administrative assistant, you will perform various tasks on a daily basis. So, you should be...

  • Medical Claims Officer

    Found in: Whatjobs AE C2 - 1 week ago


    dubai, United Arab Emirates Omega Insurance Brokers LLC Full time

    Title: Medical Claims Officer Job Location: Dubai, UAE Job Role: To attend medical approval queries and resolve the cases Maintain customer satisfaction and client retention Requirements: Education: Graduates in medical/paramedical/insurance courses or medical professionals like nurses, doctors, or pharmacists 1+ year of experience in handling Medical...


  • Dubai, United Arab Emirates Hafizullah Medical Group Full time

    Our company is looking for a Medical Records Coordinator to join our team. **Responsibilities**: - Sorting records and putting them in chronological order for the doctors; - Associates Degree; - Scanning in medical records to make them electronic files; - Make confirmation calls for appointments; - Data entry; - Answering and routing incoming calls; - Back...


  • Dubai, United Arab Emirates uniCare Medical Group Full time

    We are urgently looking for an Assistant/Junior Medical Coder to provide support for insurance-related matters (eligibility and approvals), accurate coding of claims to minimize rejections, timely resubmissions, etc. - Minimum 2 years experience in a similar role. - Bachelor’s Degree in any stream - Basic knowledge of OP insurance process including...


  • Dubai, United Arab Emirates Your Dental and Medical Center Full time

    **DESCRIPTION** A Receptionist should be able to organize and maintain patient waiting areas as well as front-desk areas. Ultimately, a top-performing Dental Receptionist will perform all duties in a manner that ensures the efficient running of the dental practice. **EDUCATION & QUALIFICATION** - Proficiency in Arabic Language - Proficiency in English...

  • Chief Medical Officer

    Found in: Talent AE C2 - 1 week ago


    Dubai, United Arab Emirates Client of Talentmate Full time

    Job DescriptionThe Chief Medical Officer is responsible for providing strategic leadership and oversight of the medical department within a healthcare organization. They will collaborate with executive leadership, medical staff, and other stakeholders to develop and implement clinical strategies, policies, and programs. The Chief Medical Officer will ensure...

  • Medical Officer

    2 days ago


    Dubai, United Arab Emirates TPA Full time

    **RESPONSIBILITIES AND DUTIES** Research and follow up on Medical Treatment patterns and conduct utilization reviews for Beneficiaries (Policyholders) & Medical Network providers, Quality control by: - Being available (On call) 24 hours a day for Claim Centre Officers queries relating to in-patient claims. - Assess day-care and in-patient cases as per...

  • Medical Officer

    3 days ago


    Dubai, United Arab Emirates TPA Full time

    **RESPONSIBILITIES AND DUTIES** Research and follow up on Medical Treatment patterns and conduct utilization reviews for Beneficiaries (Policyholders) & Medical Network providers, Quality control by: - Being available (On call) 24 hours a day for Claim Centre Officers queries relating to in-patient claims. - Assess day-care and in-patient cases as per...

  • Medical Secretary

    2 days ago


    Dubai, United Arab Emirates Fakeeh University Hospital Full time

    We are looking for a Medical Secretary to support our hospital facility. Patients, visitors and medical staff will turn to you for information and help with administrative issues. Our medical secretary should be efficient and well-spoken with experience in administration. If you are patient, computer-savvy and can multitask, we’d like to meet you. Your...


  • Dubai, United Arab Emirates Medical Devices Dubai Full time

    **Job Overview**: **Key Responsibilities**: - Effectively manage the COO's schedule, including arranging and coordinating meetings, appointments, and travel plans. - Proactively anticipate scheduling conflicts and make necessary adjustments. - Serve as the primary point of contact for internal and external communication on behalf of the COO. - Coordinate...


  • Dubai, United Arab Emirates JVJ Recruitment & Marketing Full time

    Urgently looking for an HR Officer with medical experience for international healthcare facility based in the heart of Dubai. Should be familiar with the licensing process (MOH) as well as onboarding and off boarding. Must have previous experience in a healthcare facility. Competitive salary + benefits offered. Start date is immediately. **Job Types**:...

  • Medical Claims Officer

    Found in: Whatjobs AE C2 - 1 week ago


    dubai, United Arab Emirates Omega Insurance Brokers LLC Full time

    Title: Medical Claims OfficerJob Location: Dubai, UAEJob Role:To attend medical approval queries and resolve the casesMaintain customer satisfaction and client retentionRequirements:Education: Graduates in medical/paramedical/insurance courses or medical professionals like nurses, doctors, or pharmacists1+ year of experience in handling Medical Insurance...

  • Medical Secretary

    3 days ago


    Dubai, United Arab Emirates Aim Academy & Recruitment Full time

    We are looking for a Medical Secretary to support our medical office. Patients, visitors, and medical staff will contact you for information and help with administrative issues. Our medical secretary should be efficient and well-spoken with experience running a medical office. We want to meet you if you are patient, computer-savvy, and can multitask. Your...

  • Medical assistant

    Found in: Talent AE 2A C2 - 2 weeks ago


    Dubai, United Arab Emirates PROCTER & GAMBLE Full time

    Job Description Responsible to be the administrator and ambassador for the Vibrant Living Health Center serving as the first point of contact when employees enter the Health Center. Comprised of administrative responsibilities, project management, and medical tasks. Administrative responsibilities include oversight of front office such as: ordering supplies,...

  • Medical assistant

    Found in: Whatjobs AE C2 - 1 week ago


    dubai, United Arab Emirates PROCTER & GAMBLE Full time

    Job Description Responsible to be the administrator and ambassador for the Vibrant Living Health Center serving as the first point of contact when employees enter the Health Center. Comprised of administrative responsibilities, project management, and medical tasks. Administrative responsibilities include oversight of front office such as: ordering supplies,...

  • Insurance Officer

    5 days ago


    Dubai, United Arab Emirates Al Shifa Al Khaleeji Medical Center Full time

    A reputed medical group is looking for an insurance officer. Good knowledge of insurance claim submission and reconciliation is required. **Salary**: AED5,000.00 - AED6,000.00 per month

  • Senior Medical Compliance Officer

    Found in: beBee S AE - 4 weeks ago


    Dubai, United Arab Emirates ENOC Full time

    Job Title Senior Medical Compliance OfficerBusiness CorporateJob Purpose To assist the Chief Medical Officer to develop, implement and deliver occupational health services and related health educational programs to ENOC and its affiliates including Dragon Oil and to manage the running of the Occupational Health Services Centre.Principal Accountabilities...


  • Dubai, United Arab Emirates TPA Full time

    **1.** **RESPONSIBILITIES AND DUTIES** - Should escalate all discrepancies encountered in TOB (Table of benefits), Ntouch Parameters and Network issues with the concerned departments. - Provide high quality customer service by answering customer enquiries efficiently and politely with correct and complete information and redirect them where appropriate. -...