Doctor Medical Reviewerquick apply at MedNet UAE FZ LLC / EmaratJobs
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Full-time Doctor Medical Reviewerquick apply

at MedNet UAE FZ LLC in Dubai

Job description

  • Evaluate claims (Network & Direct), provide authorizations for insured members (in-patient & outpatient) and handle calls relating to medical cases efficiently.
  • Assess risk exposure of members in line with medical underwriting policies.
  • Manage queries from providers, Insurance Companies and insured members relating to claims processing, evaluation and administration.
  • Provide medical guidance to the Claims Department staff and assistance in ICD coding.
  • Deliver excellent customer service to Insurance Companies and insured members with a view of achieving maximum client satisfaction.
  • Client Management / attending hospital visits to investigate on claims in order to minimize fraud and abuse.
  • Compile data and prepare monthly statistical reports to monitor departmental performance and medical trends.

Desired Skills and Experience

  • Medical degree (MBBS or Medcine) from a recognized University. Qualifications related to Medical Coding (eg: CPC, AHIMA) will be an advantage
  • 3-4 years of work expereince and knowledge in Managed Care field / Insurance (TPA) industry of UAE 
  • Willingness to work on shifts - morning and evening shift
  • Ability to handle pressure

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Published at 24-01-2016
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