Medical Claims Auditor

Experienced in Medical Claims Auditor in the insurance or TPA. - Coordinate with the providers or payers in case of mismatch between the provided statement of account and actual invoice submission. External Audit: Auditing the providers (Medical Documentation and Billing) - Updating the external audit report to the management - Auditing the In-patient,...

Participates in complex audits, third party audits, ad-hoc projects and assignments as defined by the Quality Auditor Team Manager. - Performs root cause analysis on audit findings to understand why the findings occurred. - Agrees suitable action plans to remove root causes and prevent findings from recurring. - Monitors performance trends and agrees...

Review and Audit Medical Claims to ensure their accuracy. - Resubmission of rejected claims - Ensure that the agreed price list and provider manual from insurance companies are followed for billing the service to the respective payers. - Ensure that the Billing officers are updated on time with the rejections and corrective action is taken to avoid such...

**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...

Insurance / TPA experience is an advantage. 1. Evaluate medical claims associated with bodily injuries due to a motor accident. 2. Medically audit in-patient claim requests and ensure that procedures are within industry standards. 3. Experience with working on Mednext system. 4. Liaise with network providers and follow up on the progression of the...

Insurance / TPA experience is an advantage. 1. Evaluate medical claims associated with bodily injuries due to a motor accident. 2. Medically audit in-patient claim requests and ensure that procedures are within industry standards. 3. Experience with working on Mednext system. 4. Liaise with network providers and follow up on the progression of the...

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...

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...

MBBS Doctor, experience in medical insurance, medical auditor and audit certification is a plus. **Job Types**: Full-time, Permanent Pay: AED10,000.00 - AED12,000.00 per month Ability to commute/relocate: - Dubai: Reliably commute or planning to relocate before starting work (required) **Education**: - Bachelor's (preferred) **Experience**: -...

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. -...

Immediately hiring Medical Claims Processor Must have 1-3 years experience in TPA/Insurance Medical Coding experience is an advantage Salary-4600 AED/month Pay: AED4,600.00 per month Ability to commute/relocate: - Dubai: Reliably commute or planning to relocate before starting work (required) Application Question(s): - Do you have Nursing/Pharmacy...

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...

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...

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...

Our client is one of the leading insurance company in the UAE. They are looking to hire a temporary Medical Claims Assistant to join their team. - An insurance & medical background particularly in handling claims - 2-3 year’s post degree UAE experience - Microsoft Excel skills - Good Office Administrative & Customer Service background - Good command in...

Our client is one of the leading insurance company in the UAE. They are looking to hire a temporary Medical Claims Assistant to join their team. - An insurance & medical background particularly in handling claims - 2-3 year’s post degree UAE experience - Microsoft Excel skills - Good Office Administrative & Customer Service background - Good command in...

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 AED/month Preference for immediate joiners Pay: AED8,000.00 per month **Experience**: - TPA/Insurance: 3 years (required) - IP...

**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...