We are currently recruiting for a leading Medical Claims Insurance company in UAE-Dubai.
Location: Dubai .
Job Description:
- Claim processing/audit all claims/scrutiny of files
- Authorization of Cashless/reimbursement request.
- Designing adequate covers and providing appropriate consultations
- Processing claim forms, adjudicate for provision of deductibles, co-pays, co-insurance maximums and provider settlements.
- Entering claims data into the system.
- Attending to queries from Members / PICs / Providers and resolving problems that results from claim settlement.
- Performing audit of randomly selected claims to ensure quality processing and detect any frauds.
- Researching claim over-payments and request funds.
- Following adjudication policies and procedures to make sure proper payment of claims.
- Providing timely and quality customer service to members, providers, and other insurance companies .
- Coordination with hospitals & clients.
- Maintaining and preparing departmental of records.
Candidate Profile:
- Bachelors Degree / Diploma in business management or related degree with a Diploma in any of the Para-Medical Courses.
- BHMS,BAMS,MBBS willing to make career in insurance can also apply.
- Minimum one year of experience in claims management in Insurance industry or TPA Company.
- Candidates working in TPA industry will be preferred.
- Good communication and interpersonal skills.
- Ambitious with ability to work under pressure
- Motivated, enthusiastic and result focused
- Possess strong interpersonal and communication skills
- Basic knowledge of relational databases and excellent knowledge of MS Office.
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