Medical Claims Executive

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...

**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...

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 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: 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, physician order's...

**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...

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...

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. -...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...