Medical Evaluation Officer Client of Jobs Abudhabi Posted on July 10, 2018 0 - 1 years Other - United Arab Emirates Any Nationality Send Me Jobs Like This SEND Alert Set Successfully Opening 01 Job Description EMAIL JOB SEND Email sent successfully. SHARE JOB Posted Date: Jul 02, 2018 Ref. JB1001852509 Share Tweet Medical Evaluation Officer Confidential Company Job Description Evaluate the medical necessity and consistency of diagnosis and procedure stated on the claims according to accepted international guidelines and guidelines for the specific country. Evaluate authorization/extension requests for complex hospitalization cases (mainly from US and Europe). Process, evaluate/adjudicate and audit within the agreed timeframe and with the expected quality. Contribute in developing, updating and implementing international guidelines Effectively liaise with providers, member and other stakeholders (answering phone calls, replying to emails etc.) in a timely and professional manner Support the claims adjudicators and case managers in dealing with complex medical related enquiries, reviewing medical reports and selecting suitable medical providers and conducting occasional follow up calls with the medical providers to check deviations in the scheduled treatments. Participate in special projects, preparation of reports and presentations. Lead discussion with medical providers and clients regarding the medical trends and guidelines. Actively propose new initiatives to control medical costs. Work shift wise as required Skills Good command of written and spoken English; knowledge of Arabic and additional languages (French, Spanish, German, Korean) is an advantage Good knowledge of international guidelines and regulations Good analytical, execution, problem solving and decision making skills Flexible and able to work under pressure Respect and maintain a high level confidentiality Proactive and results oriented whilst ensuring high quality of work Advance level of customer service orientation and professionalism in all interactions Able to work in a multi-cultural environment and promote teamwork and knowledge sharing in order to achieve goals and deliverables Good knowledge of health insurance concepts Good knowledge of Microsoft applications Education Medicine Company Industry Medical / Healthcare / Diagnostics / Medical Devices Department/Functional Area Sales / Business Development Keywords Auditing Spanish Claims Health Insurance Analytical Korean Microsoft Applications Customer Service Orientation 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 firstname.lastname@example.org People also searched for Dubai UAE All Jobs Medical Officer Jobs in Dubai Doctor Jobs in Dubai Medical Superintendent Jobs in Dubai Sales Jobs in Dubai German Jobs in Dubai French Jobs in Dubai Spanish Jobs in Dubai Medical Officer Jobs in UAE Doctor Jobs in UAE Medical Superintendent Jobs in UAE Sales Jobs in UAE German Jobs in UAE French Jobs in UAE Spanish Jobs in UAE Medical Officer Jobs Doctor Jobs Medical Superintendent Jobs Sales Jobs German Jobs French Jobs Spanish Jobs Client of Jobs Abudhabi View Contact Details Contact Name/ Designation: - Website https://jobs.abudhabi.ae/en/uae/jobs/medical-evaluation-officer-1001852509/#sthash.WLfXX5RH.dpbs 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?