Job Position: Medical Review Officer-3 months (Renewable Contract)
Job Description: Dubai – Job Description Send Email sent successfully. Our client based in UAE is looking for a Medical Review Officer for it firm.The ideal candidate is responsible for evaluation and processing of ‘high cost’ outpatient and inpatient claims such as UAE network claims, reimbursement claims, re submission claims, and reconciliation of claims Main Duties ·Evaluate medical necessity and consistency of diagnosis, procedures, drug codes and descriptions stated on the claims according to accepted medical coding rules and guidelines , Ensure accurate application of contractual prices and discounts, schedule of benefits, general exclusions, allocation of benefits, collection of deductibles, co-payments, observance of policy limits, and adherence to claims submission protocols ·Escalate observations about providers’ billing and coding trends to the supervisor. Report fraud and abuse cases to Medical Investigation and Audit Department according to set policies and procedures ·Contribute in… developing, updating and implementing the guidelines for evaluation and processing of medical claims, as well as policies and procedures and work instructions related to medical claims review and processing ·Ensure that business decisions and processes are documented in a professional way and the communication requirements are being adhered to in a timely and professional manner ·Deliver high quality customer service and respects medical and work ethics at all times ·Consistently, efficiently and effectively work on achieving the daily targets, quality benchmarks and other key performance indicators (KPIs) Industry Type : Functional Area : Desired Candidate Profile Minimum 1 year experience in clinical practice · Experience in medical claims/health insurance industry is a plus Licensure / Certification Requirements · N/A Education ·Bachelor degree in Medicine Skills and Competencies ·Good command of written and spoken English; knowledge of Arabic language…see more details
Note: This advertisement for Medical Review Officer-3 months (Renewable Contract) maybe valid for one month from the date it was posted, so don’t miss the chance and apply now!Get a job, Upload your CV to HiringUAE
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