Medical Claims Officer (UAE Nationals)
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موقع الوظيفة:
الراتب شهرياً:
تاريخ النشر:
نُشرت قبل 1 ساعة
عدد الوظائف الشاغرة:
1 عدد الوظائف الشاغرة
ملخص الوظيفة
General Overview:
We are supporting one of our healthcare clients in the UAE to hire a Medical Claims Officer with solid experience in reviewing and processing IP/OP medical claims. The ideal candidate will have a strong eye for detail good analytical skills and an understanding of medical terminology coding and policy guidelines. This role is based at Dubai Silicon Oasis.
Key Responsibilities:
- Review evaluate and process Inpatient (IP) and Outpatient (OP) medical claims with accuracy.
- Verify policy coverage limits coding accuracy and medical necessity in line with client guidelines.
- Ensure claims adjudication complies with established rules standards and procedures.
- Coordinate with internal teams TPAs and healthcare providers to obtain clarifications or missing documents.
- Detect inconsistencies errors or potential fraud and escalate appropriately.
- Meet required turnaround time (TAT) and quality benchmarks.
Key Requirements:
- UAEN with a Family Book - Mandatory
- Educational background in Pharmacy Healthcare Medical Coding Nursing or a related field.
- Prior experience in medical claims processing or adjudication is an advantage.
- Strong analytical communication and decision-making skills.
- Ability to join immediately or on short notice is preferred.
المجال
تصنيع مكونات الطيران والفضاء / خدمات العافية واللياقة البدنية / تصنيع منتجات العناية الشخصية
المهارات المطلوبة
- علم الأمراض الجلدية
- تحليلات جوجل
- التجارة
- هندسة الصيانة
- العربية
