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Medical Claims Officer

Company Name Confidential

Keywords / Skills : Medical Claims Officer, clinical experience, claims, Claims Processing, Healthcare, Health Claims

2 - 5 years
Posted: 2018-02-05

Industry
Insurance
Function
Banking, Insurance & Financial Services
Role
Claims Management
Education
Bachelor's Degree, Master's Degree
Stream:
• Medicine
• Medicine
Posted On
5th Feb 2018
Job Description
Job description
• Evaluates and processes claims in accordance with insurance policy terms and conditions, company policies and procedures according to productivity and quality standards.

• Ensures that targets are met for department Turnaround time, Quality and Productivity.

• Identify and report back any type of claims observation or issues that may affect the process.

• Collect and analyze claims data to identify and resolve errors, delayed claims, and processing issues. Providing recommendations to take steps to improve the claims processing quality standards and productivity.

• Analyze reports from the administrative software for provider and member utilization trends and identification of areas requiring further management.

• Support the Team leader / Manager in implementation of quality assurance programs in order to maintain standards of quality and minimize fraudulent cases.

• Handling medical related call queries.

• Maintain confidentiality with regard to the information being processed, stored or accessed.

• Completes other projects and duties as assigned.

Mandatory requirements

• Should be willing be to work shifts (morning, evening and night shifts)

• Must be an MBBS graduate (no other medical related education will be accepted)

• Candidates able to start immediately preferred.

• Salary offered AED 6000 (all inclusive)

• Medical license not required


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