Medical Claims Officer

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...

Receiving claims from Receiving and Dispatch Unit as per policy & procedure with high efficiency and accuracy.Review and separate received invoices according to providers before handing it over to Team Leaders – Claims for distribution.Printing out needed bordereau PDF or excel format which need to be communicated with Payers in alignment with line...

"  Job title: Medical Representative   Key Responsibilities: Presenting and promoting the company's medications to doctors, pharmacists, and other relevant healthcare professionals. Developing an in-depth understanding of company medications. Building and maintaining good business relationships with customers to encourage repeat...

" Job title: Medical Representative Key Responsibilities:Presenting and promoting the company's medications to doctors, pharmacists, and other relevant healthcare professionals. Developing an in-depth understanding of company medications. Building and maintaining good business relationships with customers to encourage repeat purchases. Following up on leads...

"Key Responsibilities: Presenting and promoting the company's medications to doctors, pharmacists, and other relevant healthcare professionals. Developing an in-depth understanding of company medications. Building and maintaining good business relationships with customers to encourage repeat purchases. Following up on leads generated by the...

"Key Responsibilities:Presenting and promoting the company's medications to doctors, pharmacists, and other relevant healthcare professionals. Developing an in-depth understanding of company medications. Building and maintaining good business relationships with customers to encourage repeat purchases. Following up on leads generated by the company. Preparing...

Ibn Al Haytham Hospital announces its desire to appoint: Medical Records Officer Job Details - He must be of Jordanian nationality with a Bachelor's degree / Diploma in Nursing. Has knowledge of medical supplies. Residents of Amman and its environs. For those with the above qualifications

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...

Contributing clinical expertise to patient care and providing guidance to junior physicians.Performing administrative duties and risk management.Ensuring the highest standards in patient care are maintained.Verifying complex diagnoses and facilitating treatment plans.Hiring, supervising, and mentoring healthcare professionals and collaborating with...

1. Organizational Setting and Work RelationshipsThe Senior Medical Admin Assistant/Nurse is under direct supervision of Senior Medical Officer (SMO).As part of the Medical Section team, and in support to the SMO, the Senior Medical Admin Assistant/Nurse will provide administrative, logistic, support to the health projects/programmes and emergency support...