Claims Officer (Abu Dhabi) - Major Healthcare TPA Confidential Company Posted on August 14, 2019 1 - 4 years Dubai - United Arab Emirates Any Graduation, Bachelor of Science(Nursing), Bachelor of Pharmacy(Pharmacy). Any Nationality, Any Arabic National, Indian Annual ticket, Medical & Life covers & visa/sponsorship Easy Apply Send Me Jobs Like This SEND Alert Set Successfully Opening 01 Job Description EMAIL JOB SEND Email sent successfully. SHARE JOB Duties and responsibilities: To approve reimbursement claims based upon member coverage & medical justification. To assist queries from providers and payers via phone calls or e-mails To maintain files for authorizations and other reports. Processing claims in line with the policy coverage and medical necessity. Be fully versed with medical insurance policies for various groups / beneficiaries. Might be required to assist in training colleagues and sharing knowledge. Able to accurately assess eligibility within the UAE (HAAD and DHA) guidelines as well as policy boundaries. Monitoring and maintaining the claims processing and adjudicating cycle in operational software system as per the defined terms and policy of the organization. Establishing strategies and implementing effective parameters for solving all possible queries within the team. Taking a lead role in assuring that the assigned tasks to the team are completed within the allocated time frame. Ensures the proper communication and implementation of new formats, training and processing rules. Maintaining both qualitative and quantitative claims measures. Ensure adherence to the predefined TATs for claims and pre-approvals Achieving required processing targets assigned by the team leader or supervisor on daily, weekly and monthly basis. Ensure compliance to any changes in terms of system parameters or process. Successfully pass the monthly audit sampling of own claims. Company Industry Insurance Department/Functional Area Doctor / Nurse / Paramedics / Hospital Technicians / Medical Research Desired Candidate Profile KNOWLEDGE, SKILLS AND EXPERIENCE University degree in any discipline of Medical/Para-medical specialization from a reputable university. Healthcare/Hospital experience for 1-2 years, in departments such as Surgery, ICU or GP, is required. 1 - 2 years of work experience in the Insurance industry is preferable but not mandatory. Excellent oral and written communication skills. Must be computer literate. Excellent command of the English language, Arabic is a definite plus. Should be a team player with an aptitude for customer service. Must be service oriented. Highly decisive with outstanding logic and reasoning skills. Candidate must be tactful and discrete while dealing with Providers or Payers; must be able to handle confidential information. Ability to work under pressure and meet tight deadlines and varying work-schedules. Keywords Claims officer Authorization Insurance Coordinator insurance specialist Claims Adjudication Claims Processing Claims Management Case Management CPC ICD-10 Easy Apply REPORT THIS JOB Disclaimer: Naukrigulf.com is only a platform to bring jobseekers & employers together. Applicants are advised to research the bonafides of the prospective employer independently. We do NOT endorse any requests for money payments and strictly advice against sharing personal or bank related information.We also recommend you visit Security Advice for more information. If you suspect any fraud or malpractice, email us at email@example.com People Looking for Major Jobs also searched Dubai UAE All Jobs Major Jobs in Dubai Colonel Jobs in Dubai Captain Jobs in Dubai Medical Jobs in Dubai Operations Jobs in Dubai Claims Adjudication Jobs in Dubai Customer Service Jobs in Dubai Major Jobs in UAE Colonel Jobs in UAE Captain Jobs in UAE Medical Jobs in UAE Operations Jobs in UAE Claims Adjudication Jobs in UAE Customer Service Jobs in UAE Major Jobs Colonel Jobs Captain Jobs Medical Jobs Operations Jobs Claims Adjudication Jobs Customer Service Jobs Additional Information Required Employer has requested some additional information along with your application for this job Cancel Login to Naukrigulf Continue using GOOGLE FACEBOOK All your activity will remain private or Forgot Password?