To approve reimbursement claims based upon member coverage & medical justification.
To assist queries from providers and payers via phone calls or e-mails
To maintain files for authorizations and other reports.
Processing claims in line with the policy coverage and medical necessity.
Be fully versed with medical insurance policies for various groups / beneficiaries.
Might be required to assist in training colleagues and sharing knowledge.
Able to accurately assess eligibility within the UAE (HAAD and DHA) guidelines as well as policy boundaries.
Monitoring and maintaining the claims processing and adjudicating cycle in operational software system as per the defined terms and policy of the organization.
Establishing strategies and implementing effective parameters for solving all possible queries within the team.
Taking a lead role in assuring that the assigned tasks to the team are completed within the allocated time frame.
Experience: 1 - 4 years
Features: Annual ticket, Medical & Life covers & visa/sponsorship
ملحوظة هامة:
وظايف نت ليست شركة توظيف وانما موقع للاعلان عن الوظائف الخالية المتاحة يوميا فى أغلب الشركات بالشرق الاوسط
,فنرجو توخى الحذر خاصة عند دفع اى مبالغ او فيزا او اى عمولات. والموقع غير مسؤول عن اى تعاملات تحدث من خلال الوظائف المعلنة.
