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Medical Claims Officer

2 months ago

Dubai, Dubai, United Arab Emirates Allianz Partners Full time
Job Summary

We are seeking a highly skilled Medical Claims Officer to join our team at Allianz Partners. As a Medical Claims Officer - Outpatient Pre-certification Specialist, you will be responsible for assessing and approving medical claims for outpatient services.

Key Responsibilities
  • Medical Claims Assessment: Evaluate medical claims for outpatient services, ensuring compliance with company policies and procedures.
  • Pre-certification: Assess and approve pre-certification requests for outpatient services, ensuring timely and accurate processing.
  • Claims Adjudication: Adjudicate claims for outpatient services, making decisions based on company policies and procedures.
  • Communication: Provide clear and concise communication to clients and internal stakeholders regarding claim status and decisions.
  • Productivity and Efficiency: Meet productivity targets and maintain high levels of efficiency in claim processing.
  • Quality Assurance: Ensure high-quality claims processing, adhering to company standards and regulatory requirements.
Requirements
  • Education: Bachelor's degree in a related field.
  • Experience: 2+ years of medical claims experience, preferably in an insurance or healthcare setting.
  • Skills: Fluency in MS Office (Excel, Word, Outlook, PowerPoint) and general internet navigation and research skills.