Medical Claims Supervisor

Communicate with hospitals to prepare invoicesRegistration of claims upon receiving. Make sure that all claims documents and details are complete (original invoices, medical reports, diagnostic procedure results, copy of referral) Medical examination to ensure that the treatments and procedures match the diagnosis.Examine whether the incurred treatments and...

Determines covered medical insurance losses by studying provisions of policy or certificate.Establishes proof of loss by studying medical documentation; assembling additional information as required from outside sources, including claimant, physician, employer, hospital, and other insurance companies; initiating or conducting investigation of questionable...

Managing and supervising the referral and claims team (referral doctors, senior claims officer, referral team leaders, Finance Officer Referral).Managing the referral and claims operation.Direct supervise and evaluate work activities Review and evaluate the periodical statistical reports.Lead the referral and claims process to obtain the best quality, cost...

Managing and supervising the referral and claims team (referral doctors, senior claims officer, referral team leaders, Finance Officer Referral).Managing the referral and claims operation.Direct supervise and evaluate work activities Review and evaluate the periodical statistical reports.Lead the referral and claims process to obtain the best quality, cost...

Managing and supervising the referral and claims team (referral doctors, senior claims officer, referral team leaders, Finance Officer Referral).Managing the referral and claims operation.Direct supervise and evaluate work activities Review and evaluate the periodical statistical reports.Lead the referral and claims process to obtain the best quality, cost...

Applying Claims Department Policy & Procedures and quality measures for processing claims.Entering data accurately in order to provide accurate records to the company and Participated Insurance Companies (PICs).Conduct Medical Audit and review sample of Processed Claims – sample defined as per confidence level target set on a yearly basis - against...

• Plan resources, manage and control overall claims processing operations for health care service providers and insured member direct claims ensuring benchmarks are met regarding execution of the different steps in the value chain for claims management proactively reducing cycle time, ensuring provision of prompt services to clients, and thus supporting...

Bachelor Degree in a Medical Background.Minimum 15+ years’ experience of professional health management with at least 10 years in managerial post,Experience in medical insurance.Previous experience in direct handling referrals and claims.Related Professional certificate is desirable.Managerial, leading and supervising skills.Experience in developing...

Ensures that medical claims, medical records and other documentation essential to the healthcare provider follow JPS agreement.Ensures record accuracy, follows up, and makes necessary revisionsProcesses changes in information system to support accurate and efficient billing process and financial close.Checking eligibility and benefits verification for...

Answer inbound calls as well as assist parties who have specific inquiries.Queries may range between coverage questions, network location and medical questions.Receive, evaluate and assess approval requests from Healthcare providers (Hospitals, Laboratories, pharmacies…)Insure that all needed required documentation (referral form, completed medical...

Receive, review and route all incoming material, indicating priority items and place the information along with any background information with the digital medical file for the attention of the physician.Exercise absolute confidentiality when dealing with medical issues.respond to enquiries of a medical-administrative nature.Prepare correspondence of a...

About the jobMedNet Jordan is one of the leading managed care service organizations that cater to healthcare needs. We are currently seeking to hire a Junior Reviewer - Medical who works on a Shift Basis with the following tasks and responsibilities: Your Job· Provide authorizations for insured members (In/Out-Patient) and handle calls relating to...

Inspecting and updating patients' charts.Diagnosing common ailments such as colds, flu, and diabetes.Administering medication topically, orally, and via intravenous or intramuscular injections.Prescribing apt medications and lifestyle alterations.Collecting fluid and tissue samples and sending these to laboratories for further testing.Referring patients...

Develop and implement organizational policies and procedures for the facility or medical unit.Develop and maintain computerized record management systems to store and process data such as personnel activities and information, and to produce reports.Direct or conduct recruitment, hiring and training of personnel.Direct, supervise and evaluate work activities...

Key ResponsibilitiesThe Supervisor, Revenue Operations is responsible for customer-centric, efficient and compliant commercial transactions for the Hikma Pharmaceuticals business. This role will plan, organize, direct and manage activities ensuring the proper and timely processing of various types of customer’s Chargeback and Rebates claims. This...

The MHPSS Technical Supervisor will provide technical supervision in group and individual settings. The person is responsible for training and supervising all paraprofessionals/ professionals holding regular individual sessions (2 sessions per month per PSW worker) and (2 group supervision sessions per month) as well as case discussions in each of his/her...

-Defining, implementing and monitoring the IPC plan for COVID-19 treatment center and Azraq Camp hospital. Setting up regular monitoring mechanisms for IPC activities, analyzing the results, identifying priorities and proposing solutions when necessary.-Establishing, maintaining and improving surveillance systems for health care associated infections in the...

- To oversee the activity in COVID treatment center and contribute to the overall management of Azraq camp hospital, in collaboration with medical, nursing and administrative staff.- Work with the department's supervisors and health coordinator to establish proper protocols for provision of services.- Manage scheduling of COVID treatment center staff and...

-Defining, implementing and monitoring the IPC plan for COVID-19 treatment center and Azraq Camp hospital. Setting up regular monitoring mechanisms for IPC activities, analyzing the results, identifying priorities and proposing solutions when necessary.-Establishing, maintaining and improving surveillance systems for health care associated infections in the...

Receive the orders from the supplier and inspect items, as to quality, quantity, and expiry dates. Provide the supplier with feedback in case of irregularityArrange stock by category and in alphabetical order, with the earliest expiring stock at the front of the shelf and the first in first out techniques “FEFO”Monitor the supply quantity,...