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    • Senior claims officer - Dubai - Alliance Insurance Abu Dhabi

    Alliance Insurance Abu Dhabi
    Alliance Insurance Abu Dhabi Dubai

    6 days ago

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    Description

    Medical Insurance Claims Examiner Role Overview

    We are seeking a highly skilled Medical Insurance Claims Examiner to join our team at Alliance Insurance Abu Dhabi.

    Key Responsibilities:

    • Receive, review, and process medical insurance claims submitted by policyholders or healthcare providers in accordance with policy terms, coverage limits, and medical necessity criteria.
    • Verify the accuracy and completeness of claim forms, medical records, and supporting documentation to ensure compliance with regulatory requirements and company policies.
    • Investigate questionable claims by contacting healthcare providers, requesting additional information or documentation, and analysing medical records to inform decision-making.
    • Maintain detailed records of claims, correspondence, and investigation outcomes in accordance with regulatory requirements and company policies.
    • Ensure timely and accurate processing of approved claims for payment, including coordinating with finance departments and third-party administrators.
    • Communicate effectively with policyholders, healthcare providers, and internal stakeholders regarding claim status, decisions, and any required actions.

    Requirements:

    • Bachelor of Medicine, Bachelor of Surgery (MBBS), Nursing degree, or relevant medical degree from an accredited institution.
    • Experience in the relevant health insurance industry is preferred.
    • Proficiency in computer skills, including Excel and other relevant software applications.
    • Strong analytical, communication, and problem-solving skills.
    • Attention to detail and ability to work efficiently in a fast-paced environment.
    • Ability to prioritize tasks and meet deadlines effectively.

    What We Offer:

    A competitive salary and benefits package, opportunities for career growth and development, and a dynamic work environment that values excellence, innovation, and teamwork.

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