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Doctor - Medical Officer
Full time at a Laimoon Verified Company in Abu Dhabi, UAE

Doctor - Medical Officer Full time at a Laimoon Verified Company in Abu Dhabi, UAE

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Posted on September 12, 2017

Job details

Required by a MNC Group for Abu Dhabi.

• Assess day-care and in-patient cases as per medical justification and policy coverage.

• Escalate and confirm grey-area cases. Confirming of exclusions of borderline cases OP/IP.

• Assists CC officers and supervisors in claims adjudication cases as needed.

• Sending request of confirmation and notification to corresponding payers as needed.

• Responding to payer's queries in relation to day-care and In-patient cases.

• Responding to the payers request for advice on coverage of cases.

• Assisting the CC Supervisors / Asst. Manager and Managers as needed.

• Rejecting not medically and policy wise not covered day-care and in-patient cases to be signed by CC Manager.

• Conformity of assessment for the prescribed tests/medications/investigations/clinical

Procedures.

• Issuing day-care and In-patient cases Reimbursement Approval in line with medical and

Policy coverage.

• Contacting provider for queries and clarifications.

• Doing clinical discussion directly with the network's doctor as needed.

• Seeking verbal clinical opinion from Network's doctor as needed.


 KNOWLEDGE, SKILLS AND EXPERIENCE 


• Doctor (MBBS degree/ MD degree)

• 2 - 5 years' experience in the healthcare industry / hospitals is preferable but not mandatory

• Basic industry knowledge (healthcare / insurance)

• Should be a team player with an aptitude for customer service

• Must be service oriented

• Excellent oral and written communication skills

• Must be computer literate

• Excellent command of the English language, Arabic is a plus

• Candidate must be tactful and discrete when dealing with clients and must be

• Able to handle confidential information

• Ability to work under pressure


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