Website National General Insurance Co.
Job Details
Job Position – Medical Claims Supervisor
Company Name – National General Insurance Co. PJSC
Location: NGI Head Office, Dubai
JOB DUTIES:
– Responsible for the screening of claims to ensure cost containment, medical necessity, and check for fraudulent activity.
– Screen all claims (e-claims and paper claims) in a proper and aggressive manner for all hospitals, clinics and pharmacies for processors.
– Check authorization of claims, policy details and wordings, coverage limit, necessity of treatment and CPT coding at time of screening.
– Managing PBM issues .
– Screening of resubmission claims.
– Attending to reconciliation with providers.
QUALIFICATIONS AND SKILLS REQUIRED
– Educational Attainment / Certifications – MBBS or equivalent qualification
– Years of experience- Minimum 2-3 year in TPA / Payer / Provider
– Industry Preferred- Insurance- medical claims and preauthorization.
– UpToDate on DRG and other UAE billing rules
– Knowledge in Medical Coding
– Advanced Excel
Email: careers@ngiuae.com
To apply for this job email your details to careers@ngiuae.com