Medical Claims Officer Nextcare Saudi Arabia

Posted on 27 Oct

Experience

3 - 8 Years

Job Location

Riyadh - Saudi Arabia

Education

MBBS(Medicine)

Nationality

Any Nationality

Gender

Not Mentioned

Vacancy

1 Vacancy

Job Description

Roles & Responsibilities

Main Tasks

Daily extraction of Inpatient report for cases within assigned region and daily assessment and evaluation of cases.
Investigate inpatient cases in order to get the correct picture with justification including management plan and to follow thoroughly serious cases even though already roved.
Coordinate with site-delegates to manage and prepare daily inpatient report.
Provide a unified and standardized roving reports on daily basis. Consolidated weekly reports for visited in-patient cases and saving achieved are provided by the end of each week and by the end of each month.
Coordinate for Cost Containment and savings measures including special discounts, transfer to low class/cost provider and case transfer to home country.
In case of suspicious activities, data shall be collected and relevant function shall be informed for their necessary actions. E.g. FWA, Pre Cert .. etc
To approve urgently required services/ procedures according to Standard Medical Practice and Evidence Based Medicine.
Follow medical guidelines, practices and regulator ( IA ) instructions.

Desired Candidate Profile

Minimum Requirements:

Bachelor of Medicine and Bachelor of Surgery MBBS
3+ years of experience in a mid-to-large sized organization in the similar role.
SCFHS
Typing and communication skills in English & Arabic.
Clean and valid Driving license.
Physically fit to carry out duties
Legally permitted to work in the country of operations.
Fluency in MS Office (Excel, Word, Outlook, PowerPoint) and general internet navigation and research skills.

Company Industry

  • Insurance

Department / Functional Area

  • Doctor
  • Nurse
  • Paramedics
  • Hospital Technicians
  • Medical Research

Keywords

  • Medical Claims Officer

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 abuse@naukrigulf.com

Nextcare Saudi Arabia

https://careers.allianz.com/global/en/job/84600/