Medical Claims officers Outpatient Pre-certification

Job SummaryWe are seeking a highly skilled Medical Claims Officer to join our team at Allianz Partners. As a Medical Claims Officer - Outpatient Pre-certification Specialist, you will be responsible for assessing and approving medical claims for outpatient services.Key ResponsibilitiesMedical Claims Assessment: Evaluate medical claims for outpatient...

Job SummaryWe are seeking a highly skilled Medical Claims Officer to join our team at Allianz Partners. As a Medical Claims Officer - Outpatient Pre-certification Specialist, you will be responsible for assessing and approving medical claims for outpatient pre-certification.Key ResponsibilitiesMedical Claims Assessment: Evaluate medical claims for outpatient...

Job SummaryWe are seeking a highly skilled Medical Claims Officer to join our team at Allianz Partners. As a Medical Claims Officer - Outpatient Pre-certification Specialist, you will be responsible for assessing and approving medical claims for outpatient services.Key ResponsibilitiesMedical Claims Assessment: Evaluate medical claims for outpatient services...

Job Summary:We are seeking a highly skilled Medical Claims Officer to join our team at Allianz Partners. As a Medical Claims Officer, you will be responsible for assessing and approving medical claims for outpatient pre-certification.Key Responsibilities:Claim Assessment: Evaluate medical claims for outpatient pre-certification, ensuring compliance with...

Job Summary:We are seeking a highly skilled Medical Claims Officer to join our team at Allianz Partners. As a Medical Claims Officer, you will play a critical role in ensuring the smooth processing of medical claims for our clients.Key Responsibilities:Claims Assessment: Assess and evaluate medical claims to determine their validity and adherence to 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...

Assesses approval of medicalapprovals as well as policy use.Checkparticular treatment plan is necessary for thepatient.Inputs verbal and written claimsapprovals regularly.Decide approvals as perpolicy conditions.Assess high-cost claims andprovide decisions on high-cost and complicatedcases.Provide clear feedback on queries fromcall Centre team.Provides...

Job SummaryWe are seeking a highly skilled Medical Claims Officer to join our team at Allianz Partners. As a Medical Claims Officer, you will be responsible for assessing medical approvals and policy use, ensuring that patients receive the necessary treatment.Key ResponsibilitiesMedical Approval Assessment: Evaluate medical approvals and policy use to ensure...

**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 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...

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: AED10,000.00 - AED12,000.00 per month **Experience**: - TPA/Insurance: 3 years...

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...

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...

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. -...

What we do The Claims Quality & Support Officer responsible for activities concerned with review and inspection to apply quality standards for operational claim processes and adjudication What you will do Prepare concise documentation and audit reports, including recommendations to claims management for improvements with corrective action plans; Audit,...

What we do The Claims Quality & Support Officer responsible for activities concerned with review and inspection to apply quality standards for operational claim processes and adjudication. What you bring Prepare concise documentation and audit reports, including recommendations to claims management for improvements with corrective action plans; Audit,...

**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...

**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...

**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...