عربي

الصفحة الرئيسية وظائف في الامارات وظائف مساعد مدير المطالبات في الامارات مساعد مدير المطالبات

Medical Claims Assistant Manager: الإمارات

NEXtCare

تم نشره يوم 11 فبراير, 2020

2 - 4 سنوات الإمارات -الامارات العربيه المتحدة

أي تخرج. أي جنسية

عدد الشواغر01

الوصف الوظيفي

ايميل الوظيفة
تم إرسال البريد الإلكتروني بنجاح.

Medical Claims Assistant Manager: UAE
The Medical Claims - Assistant Manager is responsible for supporting the Medical Claims - Manager in managing the functions of the Medical Claims Department while ensuring that departmental goals, timeline of activities, and compliance measures are met. The incumbent has the responsibility to represent himself/herself as the manager-in-charge for all functional purposes in the absence of the Manager.
Qualifications:
•Provides directives along with the Medical Claims - Manager by providing technical assistance to evaluate complex, high-cost, or escalated claims while ensuring the quality, productivity and service level targets of staff members are met according to operational measures
•Adjudicates claims at submission level for settlement between the insurer and health care provider as per policy terms and conditions
•Adjudicates claims at precertification level, authorize decision on the claim within policy terms and conditions
•Conducts Field Visits and medical records review to validate the services invoiced inside the health insurance claim
•Interprets health insurance policies and communicate with the Insurer related to the claim eligibility when necessary
•Monitors and audits daily performance to ensure the best possible customer service
•Assists in supervising team outputs as well as individual performance
•Assesses performance of the team (function) and support in developing skill sets to fulfill task requirements
•Provides ongoing support and motivations to the team and encourage their professional growth
•Continuously work to identify possible procedure inconsistencies; develop, recommend and implement improvements
•Provide support to Medical Claims - Officers to close all escalated claims queries within the agreed turn-around-time•
Escalates issues concerning the department and operations to the Medical Claims - Manager and implement recommended plan of actions.
•Suggests updates in policies and procedures within the department to be followed by the staff members
•Assist in arranging workload distribution and for ensuring adequate staffing/resources daily and on a long-term basis (including hiring process) to ensure optimal customer service
•Assist in developing and maintaining accurate MIS system that is applicable on reviewing claims for quality and compliance; evaluate statistical reports to monitor Claims trends and identify potential issues that can be managed proactively
•Suggests training requirements of staff to ensure productivity and growth
•Assist in establishing, training, and overseeing claims management practices, internal controls, technical training, policies & procedures, and process manuals
•Assist in promoting client relationships and engage in discussions that will help improve internal systems and processes
•Operate as a team player and develop strong working relationships to ensure open communication across the board
Requirements:
•Bachelor s Degree in Medicine (MBBS / MD / MBBCH)
•Minimum 2 years of clinical experience
•4+ years of related experience from TPA /Insurance / Healthcare Provider
•Insurance certifications (CII, LOMA, etc) is a plus
•Excellent communication skills in English (Arabic is a plus)
•Technical savvy; Sound knowledge in MS Office and general internet navigation
•Flexible to work on shift schedules


الإدارة

الكلمات الرئيسية

Medical Claims Assistant Manager: الإمارات

ابلاغ عن هذه الوظيفة

تنبيه:نوكري غلف فقط منصّة يجمع بين كل من الباحثين عن عمل و أصحاب العمل. ننصح المتقدمين للوظائف التحقق من شرعية أصحاب العمل المحتملين. نحن لا ندعم أي مطالبات لتحويل الأموال و ننصح بشدة ضد الإفصاح عن اي معلومات شخصية أو مالية.و ننصح أيضا زيارةتحذير أمنيللحصول على المزيد من المعلومات.إذا تشك في أي غش أو احتيال, مراسلتنا عليabuse@naukrigulf.com

NEXtCare


عرض تفاصيل الاتصال

الاتصال

الاسم / التعيين:
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موقع الكتروني http://www.nextcarehealth.com/careers/details?Career_Id=114


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