Medical Claims Lead

**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...

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

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...

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...

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...

**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 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...

**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. -...

**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. -...

**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...

**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...

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...

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...

**Summary**: Medical Claims Officer - Inpatient Precertification is responsible for managing the Inpatient Precertification cases while ensuring that departmental goals, timeline of activities, and compliance measures are met. **Main Tasks**: - Performing complete file review of high cost claims with regards to the multidisciplinary notes, TPR charts,...

A 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...

**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...

**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...