REF 1664014
07.11.2024 | Abu Dhabi | full time
General
Location: Abu Dhabi
Occupancy: full time
Description
As the medical claims specialist/examiner , you’ll determine whether patients have insurance coverage and help them with their medical claims. You’ll also make sure all actions taken are thoroughly documented and that you adhere to our policy of delivering quality customer service to each of our patients and their families. You must also ensure 100 percent legal and industry compliance throughout the entire claims process.

Medical Claims Specialist/Examiner Job Responsibilities &

> Examine claims records and forms to determine whether the patient has medical insurance.
> Review provisions of certificate or policy to determine the patient’s included medical coverage losses.
> Negotiate claim settlements and make recommendations for legal action when settlements are deemed non-negotiable.
> Complete logs, reports, forms and records to properly document medical claims.
> Reject or accept documentation, determine benefit due, and start the denial or payment process to resolve medical claims.
> Adhere to all company policies, procedures and guidelines in addition to insurance regulations at the federal and state level.
> Examine medical treatment records, police reports, physical property damage and medical bills to gauge overall extent of liability.
> Interview and communicate with claimants, police, witnesses, physicians and other necessary individuals to decide claim denial, settlement or review.
> Ensure all claims information remains confidential.
> Engage in continuing education and training opportunities when possible.
Requirements
Proven work experience as a Medical Biller or similar role
Solid understanding of billing software and electronic medical records
Must have the ability to multitask and manage time effectively
Excellent written and verbal communication skills
Outstanding problem-solving and organizational abilities
A Bachelor’s degree in business, health care administration, accounting or related field is preferred
Provisions
Salary: to be discussed
Publisher
recruitment agency
50 - 200 employees