Pre-approval Claims Officer - Insurance TPA

Job Description:

A medical claims processor validates the information on all medical claims from patients seeking payment from their insurance company. Claims must be thoroughly reviewed to ensure that there is no missing or incomplete information. In addition, a processor must keep meticulous records of claims and follow up on lapsed cases.

Medical claims processors are expected to have an extensive knowledge of medical terminology, as well as experience using a computer.

Responsibilities:

• Recording and maintaining insurance policy and claims information in a database system.
• Determining policy coverage and calculating claim amounts.
• Processing claims payments.
• Answering queries related to policy coverage criteria and guidelines.
• Complying with federal, state, and company regulations and policies.
• Approving or denying payment to doctors based on assessment of medical documents.
• Good communication skills to converse with doctors' offices or insurance companies regarding claim issues.
• Performing other clerical tasks, as required.

Job Types:

Full-time, Permanent

Pay:

AED7,000.00 - AED9,000.00 per month

Ability to Commute/Relocate:

• Dubai: Reliably commute or planning to relocate before starting work (Required)

Education:

• Bachelor's (Preferred)

Experience:

• Claims processor or in a related role: 2 years (Preferred)