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Senior Claims Reconciliation Medical Officer

2 months ago

Dubai, Dubai, United Arab Emirates Allianz Full time

Job Overview

The Senior Claims Reconciliation Medical Officer will assess from a medical perspective the Provider claims and compare their usual reasonable customary standards versus medical practices and market law.

Key Responsibilities

  • Manage routine daily claims adjudication work.
  • Coordinate workflow and meet deadlines.
  • Evaluate claims with regards to eligibility and medical standards.
  • Take decisions on high-cost and complicated cases based on standard operating procedures.
  • Investigate disputed rejected claims and respond with the appropriate justification.
  • Attend calls and emails from insurance companies, clients, and providers.
  • Analyze reconciliation files and create summaries with recommendations and actions to reduce conflicting decisions with the Providers.
  • Increase efficiency, minimize errors, and administration time.

Key Requirements

  • Bachelor's of Medicine (MBBS).
  • 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.

What We Offer

Our employees play an integral part in our success as a business. We appreciate that each of our employees is unique and has unique needs, ambitions, and we enjoy being a part of their journey. We are there to empower and encourage you with your personal and professional development, ensuring that you take control by offering a large variety of courses and targeted development programs. All that in a global environment where international mobility and career progression are encouraged. Caring for your health and wellbeing is a key priority for us. This is why we build Work Well programs to provide you with peace of mind and give the flexibility in planning and arranging for a better work-life balance.