Job Summary

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.

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 terminolog...