applicants
Senior Medical Officer
Objective:
The job holder will be responsible for reviewing, auditing medical claims, evaluate pending claims, reconciliation & handling Pre-authorization requests with assuring excellent customer service.
External Communication:
Customers, Intermediaries and Health Care Providers - For resolving queries / issues, managing relationships, pre-authorizations and conveying information.
Main Responsibilities :
Coordinate with providers to make procedures more cost effective.
Assist in managing Pre-authorization business to optimize cost efficiencies and subject to medical & policy eligibility.
Assist in implementation of medical claims processes, reconciliations protocols and to communicate & clarify to clients, providers & intermediaries.
Minimize fraud by conduction of provider visits, second opinions and profiles. Maintain documentation process in relation to providers.
Review and audit medical claims and evaluate pending claims
Reporting to : Head of Medical Claims
Subordinates : Officer - Medical Processing
Other interactions : Clients, providers & intermediaries
Number required : 2
Duration : Permanent
Desired start date : Immediately
Probation : 6 Months
Working hours : 5 days / week 8 hrs / day
Skills
Requirements
University Qualifications: MBBS/ MBChB or above
Other certifications: Insurance qualification an added advantage.
Previous experience: Medical Doctor, any department
Specialist knowledge: Strong Medical Knowledge
Other Skills: Knowledge of MS Office
Strong Analytical ability with Initiative and
Good Interpersonal and Communication skills
Strong Problem solving and decision making capabilities
Very good Written & verbal communication skills in English, Arabic preferred.
Ideal Age Range: 25 - 40
Gender Preference: Any
Nationality Preference: Any
Language Skills: English
Current Residence: Dubai, UAE
Education
MBBS: Bachelor\'s degree of Medicine.
