Job Description

Job Description:
We are seeking a highly skilled and motivated individual to join our team. Candidate who can adopt a proactive work style to evaluate claims handling processes and practices.

QUALIFICATION AND SKILLS:

• Knowledge on Medical Terminology and medical cases (Preferably knowledgeable on DRG Coding and payment calculation.)
• Experience in similar role with Insurance industry background is a plus.
• Proficient in using MS office applications with excellent communication skills.
  *Excellent analytical, problem solving skills and attention to detail. *Ability to work independently and collaborate effectively.
  KEY RESPONSTBILTTIES
• Review claim documents such as medical records, bills, etc.
• Verify eligibility and coverage for services using online tools and resources
• Assist in preparing Audit report and reports required by Authority.
• Processing Medical Claims and Reimbursement claims of members from inside or outside UAE in accordance with policies, procedures and regulatory requirements.
• Responsible to enter claims data into the system and preparation of payment s to
  providers.
• Perform reconciliation of claims and adjudication.
• Attend to queries of agents, customer or brokers related to claims.