Home Saudi Arabia Medical Claims Officer
Home Saudi Arabia Medical Claims Officer
Medical Claims Officer
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
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Confidential
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AED 61
AED 661Duration: Upto 3 Hours -
First Aid for Respiratory Problems Course LineAED 89
AED 1,690Duration: Upto 4 Hours
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