Medical Claims Officer

REF 1678005

26.11.2024 | Dubai | full time

Description: The Claims Officer assists with insurance claims for clients. He/She will review the claims submitted to ensure that they are valid. He/She collects the necessary documents for claims assessment. The Claims Officer helps to settle all claims matters accurately and fairly based on company’s guidelines. He/She also handles enquiries on insurance coverage and claims.

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.

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.
• Medical license not required
• 2 yrs minimum clinical experience