Reimbursement claims, Pre-authorization, Direct Billing claims

PPL Dynamics

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profile Job Location:

Doha - Qatar

profile Monthly Salary: Not Disclosed
Posted on: 30+ days ago
Vacancies: 1 Vacancy

Job Summary

  • University Degree or Diploma in Nursing / Medical or medical practitioner.
  • Min 4 8 years of experience (preferably relevant experience).
  • Local candidates with valid QID preferred.
  • Sound medical knowledge and willing to work in non-clinic process.
  • Minimum of 1 year experience in handling authorization.
  • Should be willing to work in shifts as the department works on 24/7 function.
  • To manage and process claims ensuring documentation verifying eligibility obtaining necessary pre-authorization and facilitate billing for the reimbursement process.
  • Provide accurate and timely medical claims handling services in accordance with company policies procedures and standards.
  • Assess evaluate and process claims in an effective and efficient manner to support the smooth operation of the Claims function.
  • Maintain detailed and accurate records of all claims assessments and decisions.
  • Liaise with internal departments and external medical providers to gather necessary information for claim adjudication.
  • Ensure compliance with regulatory requirements company guidelines and service level agreements (SLAs).
  • Contribute to the continuous improvement of claims processes and systems.
  • Be flexible in working across different types of Claims functions as assigned by management.
University Degree or Diploma in Nursing / Medical or medical practitioner. Min 4 8 years of experience (preferably relevant experience). Local candidates with valid QID preferred. Sound medical knowledge and willing to work in non-clinic process. Minimum of 1 year experience in handling authorizati...
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