التفاصيل

Medical Approval Doctor Job Details  Experience Needed: 1 To 3 Years  Career Level: Entry Level (Junior Level / Fresh Grad)  Education Level: Bachelor's Degree  Salary: Confidential  Job Categories: Medical/Healthcare Job Description  Manage routine daily claims administration work.  Responsible for transforming the medical data (diagnosis, medications, etc) in medical claims into a digital form.  Coordinate workflow & meet deadlines.  Evaluating claims with regards to eligibility.  A decision on high cost and complicated cases.  Attending emails from insurance companies or clients.  Coordinating with international providers for direct billing.  Increasing efficiency, minimizing errors, and administration time.  Reviewing, sending and following up on the additions and deletions requests.  Reviewing, archiving, sending and following up on the reimbursement claims.  Updating the system with the client’s data.  Coding of the written diagnosis using ICD-10 & CPT  Tracking all Direct Claims received from the provider according to the company standards. This role has the overall responsibility to ensure our operational standards are achieved with outmost productivity and efficiency.  Consistently checks and tracks claims received from providers which includes the following responsibilities:  Aiding the issuance team in policy renewal, consumption, and loss ratio processing.  Claims analysis and following up scheme performance.  Handling approvals whether for chronic medication or surgeries to meet the client’s needs concerning each policy.  Keen on being in contact with the key person of each policy to provide satisfactory service and solve any problems.  Receiving cheques and ensuring their delivery at the appropriate time for the client.  Able to communicate daily with different TPAs and Client requests including the following reimbursement, solving complaints, approving, and following debit notes payments, and studying exceptions.  Preparing monthly statistics.  Archiving claims boxes. Job Requirements  Bachelor Degree in Medicine and Surgery /Physician  Medical Insurance Background is a must.  Very good command of the English language.  The ability to communicate sensitively and effectively with the claims department and other departments having regard for the strict need for confidentiality.  Advanced knowledge of Microsoft packages (Word, PowerPoint, and Excel) e-mail, electronic calendar, and the Internet.  Ability to work well with all levels of internal management and staff, as well as outside clients and users