Medical Claims Processor
Transguard Group
Abu Dhabi, UAE
منذ 5 يوم
source :


Transguard WorkforceSolutions is currently recruiting for a Medical Claims Processorfor a client in the healthcare industry.

As a Medical ClaimsProcessor, you will evaluate more complex data entry, clerical, andaccounting tasks involved in the preparation and processing ofpatient insurance claims.

In this role, your responsibilities willinclude the following :

  • Ensuring thatinsurance claims information is entered into the system correctly,to ensure accurate processing and timely payment.
  • Ensuring that provider’s fees andservice items charges coincide with their existing contract pricelist of the company.
  • Ensuring theaccuracy of the entered data as per the existing standard steps andprocedures of direct claims processing.
  • Comparing data on claims applications andscreening claim documents and processing claimadjustments.
  • Ensuring payment ordersare properly created and forwarded accordingly for finaldocumentation and filing.
  • Acting as areference person for information on enquiries concerning claimsprocessing procedures.
  • Monitoringcorrect application of beneficiary share accordingly on serviceitems billed.
  • Ensuring the claims areproperly audited of all data entered with accurate medical claimsdetails.
  • Providing requisition ofoffice supplies for individual and team requirement.
  • Researching claims as needed.
  • Obtaining audit medical records to compute andrecord patient charges.
  • DesiredCandidate Profile

    The idealcandidate will have the following skills and experience :

  • Bachelor’s Degree
  • Medical background preferred.
  • At least 2 years of filing / documentationexperience.
  • Experience within thehealth care industry; TPAs, insurance companies, hospitals, medicalcenters is a plus.
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