Medical Claims Officer

NEW

REF 1710766

NEW

42 hours ago | Dubai | full time

Description: The Claims Officer assists with insurance claims for clients. He/She will review the claims submitted to ensure that they are valid. He/She collects the necessary documents for claims assessment. The Claims Officer helps to settle all claims matters accurately and fairly based on company’s guidelines. He/She also handles enquiries on insurance coverage and claims.

Job description:
• Evaluates and processes claims in accordance with insurance policy terms and conditions, company policies and procedures according to productivity and quality standards.
• Ensures that targets are met for department Turnaround time, Quality and Productivity.
• Identify and report back any type of claims observation or issues that may affect the process.
• Collect and analyze claims data to identify and resolve errors, delayed claims, and processing issues. Providing recommendations to take steps to improve the claims processing quality standards and productivity.
• Analyze reports from the administrative software for provider and member utilization trends and identification of areas requiring further management.
• Support the Team leader / Manager in implementation of quality assurance programs in order to maintain standards of quality and minimize fraudulent cases.
• Handling medical related call queries.
• Maintain confidentiality with regard to the information being processed, stored or accessed.
• Completes other projects and duties as assigned.

Requirements: Proven work experience as a Medical Biller or similar role
Solid understanding of billing software and electronic medical records
Must have the ability to multitask and manage time effectively
Excellent written and verbal communication skills
Outstanding problem-solving and organizational abilities
A Bachelor’s degree in business, health care administration, accounting or related field is preferred