Senior Officer - Reimbursement Medical Claims
MedNet UAE.
منذ 10 ساعات
source : Wisdom Jobs

The job holder will be accountable to process medical claims in a timely manner and has overall responsibility in auditing and reporting of outpatient reimbursement claims Key responsibilities are as follows -

Maintain TAT and quality standards for Reimbursement claims processing - Send electronic bordereau of the E- claims to the payers in order to inform them of approved claims and settlement amounts -

Prepare weekly and monthly processing reports for internal and external usage of information - Answer provider insured members PICs queries relating to claims processing coverage limit inquires as and when required -

Train newly hired processors PICs Brokers Insured Groups in reimbursment claims processing - Review and audit the reimbursement claims processed in line with auditing guidelines and introduce innovative ways to minimize errors and enhance quality standards -

Analyse medical trends utlilization rates and detect any fraud and abuse casesRequirementsMinimum Qualifications - Graduate of any paramedical sciences Minimum Experience -

Minimum 3-4 years of experience in Reimbursement claims processing in insurance TPA set up and prior experience in managing large teams will be a plus Job-

Specific Knowledge Skills - Knowledge relating to ICD -9 10 CPT - Computer literate and excellent knowledge of Microsoft applications -

Excellent communication and interpersonal skills - Good command of English language Arabic knowledge is an added advantage Profile Summary : KeySkills : Profile Summary : KeySkills : Company Profile : MedNet is a managed care service provider of quality solutions that meet an individuals long-

term healthcare needs and offers financial protection against unforeseen health crisis and expenses MedNet is dedicated to build long-

term relationships with customers insured members insurance companies and other entities which require managed care services by facilitating access to high quality and affordable managed care services

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