Provider Network

2 months ago


Dubai, United Arab Emirates TPA Full time

ü Provider tariff evaluation & service negotiations
- Should have good knowledge on current market trends and area wise tariff distribution to enable better negotiations
- Analyzing Dubai, Northern Emirates & Abu Dhabi provider price agreements
- New provider tariff evaluation for network empanelment
- Provider tariff revision analysis under the direct supervision of the Network Manager
- New service additions to the pricelist to be compared with relevant benchmarks & negotiate to ensure company is getting competitive rates from the market
- Provider utilization review
- Review and analysis of provider utilization as per business requirement
- Reporting the utilization trends to network manager
- System update
- Ensure provider pricelists are meeting standard coding guidelines
- Ensure all types of provider commercial agreements are updated in the system in a timely manner
- Monthly audit of system records to ensure errors if any are rectified
- Ensure pricelists and related correspondence are saved in the respective folders
- Assisting team to resolve any provider commercial agreement related queries
- Handling Payer queries related to provider commercial agreements
- Handling price related claims rejections queries from the providers and internal departments
- Claim fixing
- Ensure provider commercial agreement related claims are fixed within TAT
- Projects and ad-hoc tasks
- Assisting network manager in projects related to provider commercial agreements
- Handling regulator implementation projects like DRG, CPT coding changes etc.
- Assisting network manager in cost containment projects
- Training team members on price analysis and system update if required by business

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

Pay: AED7,000.00 - AED8,000.00 per month

Ability to commute/relocate:

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

**Education**:

- Bachelor's (preferred)

**Experience**:

- Insurance: 2 years (preferred)


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