Medical Claims Executive

3 weeks ago


Dubai, United Arab Emirates Solomon People Solutions Full time

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 reimbursement claims processes & network related issues.
- Assess risk exposure of members in line with medical underwriting policies.
- Manage queries from providers, Insurance Companies and insured members relating to pre-approval decisions, evaluation and administration.
- Provide medical guidance to the Department staff.
- Deliver excellent customer service to insured members with a view of achieving maximum client satisfaction.
- Client Management / attending hospital visits to investigate on claims in order to minimize fraud and abuse.
- Compile data and prepare monthly statistical reports to monitor departmental performance and medical trends.
- Orientations for newly added clients and help them to understand table of benefit.

Your Profile:

- Medical Degree (MBBS or equivalent) from a school recognized by the WHO.
- 1-2 years of experience in Medical Claims Evaluation preferably from insurance broker
- Industry knowledge related to local healthcare services system.
- Good interpersonal and negotiation skills
- Excellent written and verbal communication skills
- Strong leadership, planning and organizational skills
- Analytical and problem-solving skills
- Ability to handle stress

**Job Types**: Full-time, Permanent

**Salary**: AED3,500.00 - AED5,000.00 per month

**Education**:

- Bachelor's (preferred)

**Experience**:

- Medical Insurance Claim: 1 year (required)

**Language**:

- English, Hindi (preferred)

**Speak with the employer**
+91 8296098447



  • Dubai, Dubai, United Arab Emirates NEXTCARE Claims Management LLC Full time

    Job DescriptionWe are seeking a highly skilled Medical Claims Specialist to join our team at NEXTCARE Claims Management LLC.About Us:NEXTCARE Claims Management LLC is a leading provider of claims management services. With a strong commitment to excellence, we strive to deliver high-quality solutions to our clients.Job Summary:The successful candidate will be...


  • Dubai, United Arab Emirates WeSource Full time

    Monthly Salary: AED3,500 - AED5,000 - Working days : hours: 9hrs/5days a week - Contract Period :Full Time - Can join Immediately - Experience required: 1-2 years of experience in Medical Claims Evaluation preferably from insurance broker - Medical Degree (MBBS or equivalent) from a school recognized by the WHO. - Job Location: Dubai **Job Role**: -...


  • Dubai, United Arab Emirates NATIONAL GENERAL INSURANCE CO (PSC) Full time

    **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...


  • Dubai, United Arab Emirates Earnest Insurance Brokers Full time

    **Medical Claims Executive** **Job description**Responsibilities: - Analyze and investigate complicated insurance claims to help prevent fraud. - Perform detailed site inspections. - If necessary, provide well-informed court testimonies. - Review and process new claims reports and court verdicts. - Uphold relationships and communication with insurance...


  • Dubai, United Arab Emirates Earnest Insurance Brokers Full time

    **Medical Claims Executive** **Job description**Responsibilities: - Analyze and investigate complicated insurance claims to help prevent fraud. - Perform detailed site inspections. - If necessary, provide well-informed court testimonies. - Review and process new claims reports and court verdicts. - Uphold relationships and communication with insurance...


  • Dubai, United Arab Emirates Earnest Insurance Brokers Full time

    **Medical Claims Executive** **Job description**Responsibilities: - Analyze and investigate complicated insurance claims to help prevent fraud. - Perform detailed site inspections. - If necessary, provide well-informed court testimonies. - Review and process new claims reports and court verdicts. - Uphold relationships and communication with insurance...


  • Dubai, Dubai, United Arab Emirates NEXTCARE Claims Management LLC Full time

    Job OverviewNEXTCARE Claims Management LLC is seeking a skilled Healthcare Claims Advisor to promote and sell PATYKA's premium skincare products to healthcare professionals.About the Position:The successful candidate will be responsible for various tasks including product promotion, relationship management, market analysis, and administrative duties.Key...


  • Dubai, Dubai, United Arab Emirates NEXTCARE Claims Management LLC Full time

    About the RoleWe are looking for a skilled Clinical Assessment Expert to promote and sell PATYKA's premium skincare products to healthcare professionals.About Our Company:NEXTCARE Claims Management LLC is a reputable claims management company committed to delivering exceptional services.Job Description:The successful candidate will be responsible for various...


  • Dubai, United Arab Emirates Dubai Limited Investment Full time

    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...


  • Dubai, United Arab Emirates Dubai Limited Investment Full time

    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...


  • Dubai, Dubai, United Arab Emirates Abroad Work Full time

    Abroad Work: Medical Claims Officer - Insurance Opportunity in DubaiAs a medical claims officer, you will validate information on clinical claims from individuals seeking payment from their insurer. Extensive examination of claims is required to ensure no missing or insufficient details. You must maintain accurate records of insurance claims and address...


  • Dubai, United Arab Emirates Dubai Limited Investment Full time

    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...


  • Dubai, United Arab Emirates Allianz Partners Full time

    **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...


  • Dubai, United Arab Emirates Dubai Limited Investment Full time

    We are immediately hiring a Medical Claims Auditor for our TPA insurance company-Almadallah Healthcare Medical/Paramedical background with good medical coding & data analysis skills Conduct data driven onsite audits to healthcare providers Checking & evaluating accurately the medical records and related documents of the medical claims to identify any...


  • Dubai, Dubai, United Arab Emirates Liva Group Full time

    Job Title: Inpatient Review CoordinatorThe Inpatient Review Coordinator plays a critical role in ensuring the accuracy and completeness of medical claims submitted by healthcare providers. Key responsibilities include reviewing patient information, medical records, and service details to verify the correctness of claims.The primary objective is to ensure...


  • Dubai, United Arab Emirates Dubai Limited Investment Full time

    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...


  • Dubai, United Arab Emirates Dubai Limited Investments Full time

    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...


  • Dubai, United Arab Emirates TPA Full time

    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,...


  • Dubai, United Arab Emirates Commercial Insurance Brokerage Services LLC Full time

    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...

  • Snr. Claims Submission

    22 hours ago


    Dubai, United Arab Emirates Biosytech Medical Laboratory Full time

    Minimum 3+ years experience in a similar role. - Must have experience of managing claim submissions & resubmissions. - 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...