Job purpose Supports health claims management, handles health claims assessments for Group and Individual Health business and service models, and assists with complaint reviews and client satisfaction.
Area of knowledge Health claims management. Health claims assessments. UAE health insurance regulations.
Main responsibility Handles health claims pre-approvals, assessments, reviews, and provides claims decisions. Handles the relationship and communication with partners and reinsurance companies. Handles claims inquiries, escalations and complaints shared by regulatory bodies, clients, members, distributors, or any other internal or external party; as well as handles communication with the medical providers to resolve and conclude the said inquiries and escalations in a professional and short response time; maintaining a highly professional and respectful communication style. Monitor trends in inquiries and escalations, and alert management to any abnormal or recurring patterns.
Number of years of experience Minimum 3 years of experience in a field relevant to the skills and experience required for the role.
Education Bachelor's Degree in a medical field.
Location Dubai or Abu Dhabi office.