Home Saudi Arabia Medical Claims Officer

Home Saudi Arabia Medical Claims Officer

Medical Claims Officer

Full time at a Laimoon Verified Company in Saudi Arabia
Posted on November 3, 2024

Job details

Hiring Medical Claims Officer with MBBS Degree for Insurance Domain Client in Riyadh, KSA.Responsibilities:Process all (Direct Billing and RI claims) the daily batches of claims assigned in line with medical policy and Inpatient adjudication guidelines.Achieve daily target in terms of number of claims processed within the defined regulatory timeframe.Ensure that the claims are paid as per the eligible benefit and coverage.Discuss all high profile/high value claims with the claims medical manager/TL where the decision is difficult & well thought.Monitor and record the medical abuse and refer the suspected fraud claims to the Audit and investigation team.Monitor the prices and calculation discrepancies while processing the claims and report the claims which are over invoiced and or have unagreed service codes to the relevant Network team.Apply the medical skills and expertise to apply the rejections wherever is applicable.Assist in additional tasks whenever assigned by the claims Manager/TL.Application: Kindly send CVs to jobs1@arab-house.com

#J-18808-Ljbffr Healthcare

Apply safely

To stay safe in your job search, information on common scams and to get free expert advice, we recommend that you visit SAFERjobs, a non-profit, joint industry and law enforcement organization working to combat job scams.

Share this job
Improve your chance to get this job. Do an online course on Healthcare and Medical starting now. Claim $10 promo towards online courses. See all courses
See All Medical Jobs
Feedback Feedback