Medical Claims Adjudicator / Processor

Job Listing No: 9740000

Medical Claims Adjudicator / Processor

Adjudicate and process all e-Claims (OP / IP / e-Resubmission), paper claims, and reimbursement claims on medical claims processing application.
• Cross check claims against prior approval (PAR)
• Review member eligibility when necessary
• Assess medical necessity, frequency, and unbundling
• Check fee guide for agreed tariff when necessary
• Apply HAAD, DHA, and generally accepted processing guidelines
Process claims on time meeting productivity targets and quality targets
Perform additional claims related tasks as assigned by manager
Support claims team by working on different types of claims as work requires

Job Details

Date Posted:2016-08-24
Job Location:United Arab Emirates
Job Role:Healthcare/Medical
Company Industry:Other

Preferred Candidate

Career Level:Mid Career

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