Senior Medical Claims Officer

#Hiring #MedicalClaims Professional from #TPA / #InsuranceIndustry

Job Title: Senior Medical Claims Officer
Location: Dubai

𝐐𝐮𝐚𝐥𝐢𝐟𝐢𝐜𝐚𝐭𝐢𝐨𝐧𝐬 𝐚𝐧𝐝 𝐒𝐤𝐢𝐥𝐥𝐬:
·       Bachelor’s degree in a relevant field, such as Nursing, B.Pharm, MLT
·       At least 2 years of experience in medical claims processing or a related field
·       Familiarity with insurance policies and regulations
·       Excellent communication and negotiation skills
·       Candidate should be well versed with IP approval claims.
·       Knowledge of CPT coding
·       Should know how to control the cost of claims.
·       A pharmacist with the above experience will be an added advantage.

𝐉𝐨𝐛 𝐑𝐞𝐬𝐩𝐨𝐧𝐬𝐢𝐛𝐢𝐥𝐢𝐭𝐢𝐞𝐬:
·       Evaluate and process medical insurance claims in a timely and accurate manner.
·       Verify policy coverage and eligibility for medical treatments and procedures.
·       Communicate with healthcare providers, policyholders, and other stakeholders to gather necessary information for claims processing.
·       Analyze medical records and invoices to determine the validity and accuracy of claims.
·       Negotiate with healthcare providers to ensure reasonable and fair pricing for medical services.
·       Review and investigate potentially fraudulent or suspicious claims.
·       Work closely with other claims team members to ensure consistency and quality in claims processing.
·       Maintain accurate records of claims and related documentation.
·       Keep up to date with changes in medical procedures and insurance policies.
·       Provide excellent customer service to policyholders and healthcare providers.

Interested contenders may apply here or email their application to umer.farooqui@metierme.net with the subject line mentioned as ‘Medical Claims Officer’.