General Practitioner

• Ensuring error free processing of preauthorization within agreed TAT (Turnaround time) by way of following the process.
• Inform providers as needed and file completed precertification requests as per procedures
• Interacting with providers to complete the claim documentation etc. As and when required.
• Ensure the accuracy of all the authorization approval as per the process.
• Any authorization not as per the limit or as per the process to be escalated to the team manager on priority.
• Ensuring process compliance is met as per regulatory procedures.
• Maintaining Daily excel maintenance for Pre-auth cases received and processed.
• Solving customer queries wherever medical opinions are required and need to be address by the medical practitioner.
• Receive and process complaint, request received from customer care
• Detect fraud and raise the suspected cases to the concerned team
• Follow all relevant departmental policies, processes, standard operating procedures and instructions so that work is carried out in a controlled and consistent manner.
• To manage claims and ensure that internal KPI’s are met as per the procedure manual.

Job Type: Full-time

Pay: QAR9,250.00 - QAR11,400.00 per month

Application Question(s):

• Are you comfortable working in Insurance Industry?

Education:

• Bachelor's (Required)