Medical Claims Officer
6 months ago
**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 patient.
- Refers for a second opinion for cases where there is doubt in treatment plan.
- Maintains daily productivity targets and service levels.
- Manages routine daily claims administration work.
- Coordinates work flow & meet deadlines.
**Behavioral Requirements**
- Strong verbal and written communication skills.
- Show flexibility, excellent interpersonal skills.
- Team Player.
- Attention to detail and quality.
- Ability to work well with all levels of internal management and staff, as well as outside clients and users.
- Ability to train other staff.
- The ability to communicate sensitively and effectively with claims department and other departments having regard for the strict need for confidentiality.
- Experience of working with senior managers and understanding the necessity to act in a pleasant and courteous manner and to be able to work effectively with others.
- The ability to exercise initiatives and be able to work flexibly under pressure and to tight deadlines.
**Behavioral Competency**
**Customer & Market Excellence**:
- Strive for excellence at every touch point with the customer
- Foster state-of-art technical/operational knowledge and strive for continuous simplification
- Be the benchmark
**Collaborative Leadership**:
- Empower the team and provide purpose and direction
- Develop people, provide feedback and care to employee wellbeing
- Collaborate and exchange best practice.
**Entrepreneurship**:
- Act on opportunities, anticipate trends, take risk, and promote a culture that allows for honest failure
- Take ownership and responsibility
- Embrace innovation and a culture that allows to make decisions without fear of retribution.
**Trust**:
- Act with integrity, honor commitments, tell the truth
- Foster diversity and inclusiveness
Act transparently and promote corporate social responsibility.
**Minimum Requirements**
- Education: Bachelor’s of Medicine (MBBS)
- Experience: 2+ years Medical Practical Experience (reputable insurance provider, broker or a TPA experience a plus)
- Physically fit to carry out duties
- Legally permitted to work in the country of operations.
- Fluency in MS Office (Excel, Word, Outlook, PowerPoint) and general internet navigation and research skills
**Job Level**:
Professional
**Location**:
- Dubai, AE**Area of Expertise**:
Operations
**Unit**:
Allianz Partners
**Employing Entity**:
NEXTCARE Claims Management LLC
**Job Type**:
Full-Time
**Remote Job**:
Hybrid working
**Employment Type**:
Permanent
**ID**:
36644
-
Medical Claims Officer
6 months ago
Dubai, United Arab Emirates Dubai Limited Investment Full timeWe 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...
-
Medical Claims Officer
6 months ago
Dubai, United Arab Emirates Dubai Limited Investment Full timeWe 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...
-
Medical Claims Officer
4 months ago
Dubai, United Arab Emirates Dubai Limited Investment Full timeWe 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...
-
Medical Claims Officer-ip
3 months ago
Dubai, United Arab Emirates Dubai Limited Investment Full timeWe 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...
-
Medical Claims Officer
6 months ago
Dubai, United Arab Emirates Allianz Partners Full time**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...
-
Medical Insurance Claims Officer
6 months ago
Dubai, United Arab Emirates TASCoutsourcing Full timeExamine 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...
-
Medical Claims Officers
6 months ago
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...
-
Claims Officer
6 months ago
Dubai, United Arab Emirates TPA Full timeA medical claims processor validates the information on all medical claims from patients seeking payment from their insurance company. - Claims must be thoroughly reviewed to ensure that there is no missing or incomplete information. - In addition, a processor must keep meticulous records of claims and follow up on lapsed cases. - Medical claims processors...
-
Medical Claims Officer
6 months ago
Dubai, United Arab Emirates Allianz Partners Full time**SUMMARY** The Senior Medical Claims - Officer will provide quality service to clients, promptly and effectively assesses and process claims and approval according to operations set standards. **MAIN TASKS** Manages routine daily claims administration work. Coordinates work flow & meet deadlines. Evaluates claims with regards to eligibility. Takes...
-
Medical Claims Officer
6 months ago
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...
-
Medical Claims Supervisor
6 months 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...
-
Medical Claims Lead
6 months ago
Dubai, United Arab Emirates Allianz Partners Full timeThe 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 Officer-tpa Insurance
4 weeks ago
Dubai, United Arab Emirates Dubai Limited Investments Full timeWe are immediately hiring a Medical Claims Officer Must have 1-3 years of experience in TPA/Insurance Must be MBBS Doctor who has experience in IP approval Salary-10000 AED/month Pay: AED8,000.00 per month Ability to commute/relocate: - Dubai: Reliably commute or planning to relocate before starting work (required)
-
Claims Officer
6 months ago
Dubai, United Arab Emirates Allianz Partners Full time**JOB DETAILS** The role of Claims Officer involves processing medical claims for clients worldwide. We ensure a high level of client service while processing claims within an industry leading 48 hours. The Claims Department is a very fast paced and challenging environment, with many different languages used and a mixture of cultures. **KEY...
-
Op Medical Claims Officer
3 months ago
Dubai, United Arab Emirates Almadallah Healthcare Management Full time**Educational background**: - Nurse, Pharmacist, Lab technician or M.B.B.S Doctor **Minimum requirement for the position**: - At-least 2 years experience in clinical practice or TPA/ insurance background. **Skills Required**: - Proficient in English - Soft skills of Ownership - Assertiveness - Punctuality - Team Player - Customer Services and...
-
Op Medical Claims Officer
3 months ago
Dubai, United Arab Emirates Almadallah Healthcare Management Full time**Educational background**: - Nurse, Pharmacist, Lab technician or M.B.B.S Doctor **Minimum requirement for the position**: - At-least 2 years experience in clinical practice or TPA/ insurance background. **Skills Required**: - Proficient in English - Soft skills of Ownership - Assertiveness - Punctuality - Team Player - Customer Services and...
-
Nurse - Claims Officer - Insurance
6 months ago
Dubai, United Arab Emirates TPA Full timeA medical claims processor validates the information on all medical claims from patients seeking payment from their insurance company. - Claims must be thoroughly reviewed to ensure that there is no missing or incomplete information. - In addition, a processor must keep meticulous records of claims and follow up on lapsed cases. - Medical claims processors...
-
Medical Claims Officer
6 months ago
Dubai, United Arab Emirates Allianz Partners Full time**SUMMARY** The Medical Claims Officer will provide quality service to clients, promptly and effectively assesses and process claims and approval according to operations set standards. **MAIN TASKS** - Manages routine daily claims administration work. - Coordinates work flow & meet deadlines. - Evaluates claims with regards to eligibility. - Takes...
-
Medical Claims Assessor
6 months ago
Dubai, United Arab Emirates Allianz Partners Full time**Summary** The Medical Claims - Assessor will provide quality service to clients by promptly and effectively assessing and processing claims and approval according to operations set standards. **Main Tasks** - Manages routine daily claims administration work. - Coordinates work flow & meet deadlines. - Evaluates claims with regards to eligibility. -...
-
Medical Claims Assessor
6 months ago
Dubai, United Arab Emirates Allianz Partners Full time**Summary** The Medical Claims - Assessor will provide quality service to clients by promptly and effectively assessing and processing claims and approval according to operations set standards. **Main Tasks** - Manages routine daily claims administration work. - Coordinates work flow & meet deadlines. - Evaluates claims with regards to eligibility. -...