Industry: Insurance
Total Positions: 1
Job Type: Full Time/Permanent
Gender: No Preference
Salary: 3800USD - 5000USD (Monthly)
Education: Bachelor′s Degree
Experience: 4-10 Years
Location: Muscat, Oman
Skills: Examining, Resolving ,Documentation Medical Claims
Posted Date: 08-06-2021
Description:
Position Summary
Medical Claims Officer – Insurance will determine whether patients have insurance coverage and help them with their medical claims. Serves medical insurance customers by determining insurance coverage; examining and resolving medical claims; documenting actions; maintaining quality customer services; ensuring legal compliance.
Key Responsibilities
· Examine claims records and forms to determine whether the patient has medical insurance.
· Review provisions of certificate or policy to determine the patient’s included medical coverage losses.
· Negotiate claim settlements and make recommendations for legal action when settlements are deemed non-negotiable.
· Complete logs, reports, forms and records to properly document medical claims.
· Reject or accept documentation, determine benefit due, and start the denial or payment process to resolve medical claims.
· Adhere to all company policies, procedures and guidelines in addition to insurance regulations at the federal and state level.
· Examine medical treatment records, police reports, physical property damage and medical bills to gauge overall extent of liability.
· Interview and communicate with claimants, police, witnesses, physicians and other necessary individuals to decide claim denial, settlement or review.
· Ensure all claims information remains confidential.
· Engage in continuing education and training opportunities when possible.
Requirements
· Degree / Diploma in Medicine or equivalent qualifications
· At least two years of experience as a medical claims Officer
· Knowledge of Medical / Healthcare / Hospital / Medical insurance regulations.
· Candidates currently in Oman with NOC / Local Release (or with GCC experience).
Immediate requirements, Attractive Salary, and Benefits