Healthcare Audit Executive
AXA
UNITED ARAB EMIRATES-UNITED ARAB EMIRATES-DUBAI
منذ 6 يوم

Job Purpose :

  • To be responsible for performing providers Audit Campaign, and identifying unfavorable trends in providers billing, maximize audit findings and recovery through providing solid audit ground.
  • Main Responsibilities :

    You will :

  • Identify the unfavorable trends in medical practice of the providers;
  • Communicate identified issues and recommendation for improvement with the FWA Process manager;
  • Ensure compliance with legal and regulatory claims management, liaising with compliance and legal to ensure the fulfillment of regulatory requirements;
  • Liaise with other FWA Unit to develop Audit campaign on targeted providers improve and develop Audit criteria to expand the current audit activities;
  • Support FWA analyst through clinical validation of the analysis;
  • Report audit findings in a constructive approach to ensure best outcomes from the performed campaign;
  • Identify areas of Gaps caused by current processes, report it for better controlled processed;
  • Onsite File review for cases reported by the Medical Board team of possible document manipulation / fraud;
  • Qualifications

    Minimum Requirements :

  • Proficient Knowledge of the Country’s healthcare Insurance market;
  • Proficient Knowledge of GCC countries healthcare providers trends and behaviors;
  • Proficient Knowledge of the various GCC countries legislations and regulations;
  • Sound Medical Knowledge and claims adjudication;
  • Coding certification;
  • Preferably Audit certification;
  • Completed Bachelor Degree in Paramedical Courses like Nursing, Physical Therapy, Pharmacy, Medicine and Medical Technology.
  • At least 3 years experience in a similar role in Healthcare Audit with coding experience.
  • About AXA

    Would you like to wake up every day driven and inspired by our noble mission and to work together as one global team to empower people to live a better life?

    Here at AXA we strive to lead the transformation of our industry. We are looking for talented individuals who come from varied backgrounds, think differently and want to be part of this exciting transformation by challenging the status quo so we can push AXA - a leading global brand and one of the most innovative companies in our industry - onto even greater things.

    In a fast-evolving world and with a presence in 64 countries, our 166,000 employees and exclusive distributors anticipate change to offer services and solutions tailored to the current and future needs of our 103 million customers.

    With a workforce of over 1,000 employees, 44 branches & retail shops region-wide, more than 1 million customers and 2015 gross written premium of over US$ 963 million, AXA is one of the largest international player in the GCC.

    Present in the region for more than 65 years, AXA in the Gulf offers a wide range of insurance products and services for corporate, SME and individual customers.

    Our business is to protect people over the long term. We emphasis on designing reliable solutions to meet the needs of our customers, manage risks in a professional way, treat our partners fairly, develop a work environment built on strong values, relationship and trust

    We also believe that we have a role to play in protecting the environment, supporting the communities in which we operate, and more broadly in helping to create stronger and more sustainable societies.

    This is part of creating a sustainable, long-term business, and becoming the preferred company for our customers, employees, and other stakeholders.

    AXA Gulf has been awarded General Insurance Company of the Year for 2nd consecutive year and Health Insurance Company of the Year at the 2015 Middle East Insurance Industry Awards (MIIA), Insurer of the Year and Personal Lines insurer in 2016 at the MENA Insurance Awards and Best Motor Insurance Product by the Banker Middle East in both UAE & KSA.

    As part of AXA’s corporate responsibility and its commitment to building better understanding about the health risks faced by individuals and the society, the company achieved a new Guinness world record for the most blood cholesterol readings in 8 hours at a single venue.

    What We Offer

    We are investing significantly in the Gulf region and we recognise the important role employees have in the success of our business.

    We offer excellent opportunities for motivated and talented candidates whether at entry level or at c-suite level.

    We value diversity and we encourage applicants of various backgrounds and nationalities to join our team.

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