Medical Claims Supervisor

2 weeks ago


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 processors.
- Check authorization of claims, policy details and wordings, coverage limit, necessity of treatment and CPT coding at time of screening.
- Managing PBM issues.
- Screening of resubmission claims.
- Attending to reconciliation with providers.
- Attending to reimbursement claims Healthnet and Neuron.
- Escalate complicated and suspected fraud cases to higher management to minimize fraudulent claims.
- Coordinate with Network department to ensure prices are in balance as per services and standards
- Attend to and provide exemplary customer service to any incoming calls from customers, providers or business development executives
- Any additional tasks assigned by manager, as per changing business need.
- Able to work in shifts, especially weekends.

**Qualifications**:

- Educational Attainment / Certifications - MBBS or equivalent qualification
- Years of experience
- Minimum 2-3 year in TPA / Payer / Provider
- Industry Preferred
- Insurance
- medical claims and preauthorization.

**Skills Required-**

Ø UpToDate on DRG and other UAE billing rules

Ø Knowledge in Medical Coding

Ø Advanced Excel

Ability to commute/relocate:

- Dubai: Reliably commute or planning to relocate before starting work (required)


  • Claim Supervisor

    2 months ago


    Dubai, United Arab Emirates Apt Resources Full time

    **CLAIM SUPERVISOR**: **Job ID **:1808 **Location **:Dubai - United Arab Emirates **Industry **:Automotive **Functional Area **:Installation / Maintenance / Repair AED 5,000.00 - 6,000.00 **Other Benefits **:As per the Labour Law **GCC Driving License **:Yes **Description: - This position will be responsible for leading the daily activities of Auto...

  • Claim Supervisor

    5 days ago


    Dubai, Dubai, United Arab Emirates Apt Resources Full time

    CLAIM SUPERVISOR:Job ID :1808Location :Dubai - United Arab EmiratesIndustry :AutomotiveFunctional Area :Installation / Maintenance / RepairAED 5, ,000.00Other Benefits :As per the Labour LawGCC Driving License :Yes**Description: - This position will be responsible for leading the daily activities of Auto Claims Warranty. Requirement - Holding a mechanical...

  • Medical Claims Auditor

    2 months ago


    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, United Arab Emirates Sav Full time

    1. Evaluating 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 cases. 5. To liaise with internal stakeholders...


  • Dubai, United Arab Emirates Sav Full time

    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...


  • Dubai, United Arab Emirates Sav Full time

    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...

  • Medical Coder

    3 weeks ago


    Dubai, United Arab Emirates Biosytech Medical Laboratory Full time

    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. -...


  • 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...

  • Medical Claims Doctors

    2 months ago


    Dubai, Dubai, United Arab Emirates MIDDLE-EAST Jobhunters Full time

    We are in search of committed and qualified candidates for Medical Claims Doctors to join the Medical Claims Department at our client's Healthcare Establishment in Dubai, United Arab Emirates (UAE).The applicants are expected to meet the following requirements -MBBS or Professional License (Passed Board/Bar/Professional License Exam) in Medicine or...


  • Dubai, Dubai, United Arab Emirates MIDDLE-EAST Jobhunters Full time

    We are in search of committed and qualified candidates for Medical Claims Doctors to join the Medical Claims Department at our client's Healthcare Establishment in Dubai, United Arab Emirates (UAE).The applicants are expected to meet the following requirements -MBBS or Professional License (Passed Board/Bar/Professional License Exam) in Medicine or...


  • Dubai, Dubai, United Arab Emirates MIDDLE-EAST Jobhunters Full time

    We are in search of committed and qualified candidates for Medical Claims Doctors to join the Medical Claims Department at our client's Healthcare Establishment in Dubai, United Arab Emirates (UAE).The applicants are expected to meet the following requirements -MBBS or Professional License (Passed Board/Bar/Professional License Exam) in Medicine or...


  • 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: AED8,000.00 - AED9,000.00 per month Application Question(s): - Do you have...


  • Dubai, Dubai, United Arab Emirates Black Pearl Consult Full time

    Medical Insurance Supervisor | Black Pearl Consult DubaiBlack Pearl is a human resources and recruitment agency that provides a holistic business and talent solution in a progressive, dynamic, and efficient way.We pride ourselves as a unique black pearl and strive to delight our clients with a personalized partnership that helps them propel towards...


  • 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, Dubai, United Arab Emirates Dubai Limited Investment Full time

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


  • Dubai, United Arab Emirates Earnest Insurance Brokers Full time

    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...


  • Dubai, Dubai, United Arab Emirates Sav Full time

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

  • Medical Claims Lead

    2 weeks ago


    Dubai, United Arab Emirates Allianz Partners Full time

    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...

  • Medical Claims Auditor

    2 months ago


    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...