insurance claims processor

Nextcare

<div>
 
 Job Overview
 
 
 
 The
 
 Claims Payment Processor &amp; Reconciliation
 
 
 Officer
 
 main duties are; to manage financial transactions between medical providers, insurance companies, and internal finance teams to ensure timely and accurate claims payments, resolve any discrepancies, to report the processed claims to the payer, prepare EFTs (Electronic fund transfer) for claims, updates the accounting and other financial software, and send statement of accounts and outstanding to our clients. This role also incudes the receivables calculation and collection from Providers.
 
 
 
 What You Do
 
 
 
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 Generates regularly outstanding reports from all the payers and send them to the payers monthly
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 Prepare the payments for the providers within the TAT
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 Monitors the Claims aging payments flow from all payers and follow up on payments when needed.
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 Ensures the financial transactions are booked in a timely manner and are compliant with proper supporting backup.
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 Ensures control procedures are followed.
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 Ensures all accounting deadlines are met.
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 Provides professional correspondence internally and externally, i.e. members of insurance companies and their client-related claims.
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 Resolves discrepancies.
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 Monitors transactions to determine accuracy, completeness and conformance to established policies and internal procedures.
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 Keeps track of records and files and provide correct information of record details when required.
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 Calculation and collection of receivables from the providers.
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 Organizes all data and files for easy access
 
 
 </li>
 </ul>
 
 What You Bring
 
 
 
 <ul>
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 Bachelor&rsquo;s Degree; Finance / Account or equivalent background preferred.
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 1+ years relevant experience; in a TPA , Hospitals or Medical Centers is an added advantage.
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 High sense of responsibility
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 Team player.
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 Physically fit to carry out duties.
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 Legally permitted to work in the country of operations.
 </li>
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 Fluency in MS Office (Excel, Word, Outlook, PowerPoint) and general internet navigation and research skills
 
 
 </li>
 </ul>
 At Allianz Partners, AI is revolutionizing customer service and claims management through innovative solutions. These AI-driven tools enhance productivity by streamlining complex claims processes, reducing administrative burdens, and accelerating resolution times. Our AI-powered technology has made claims processing faster, offering quicker resolutions. All while ensuring human oversight for claims to maintain service integrity. By embracing AI and Emerging Technologies, Allianz Partners continues to lead the industry, meeting ever-changing customer needs with innovative solutions. Our commitment to Ethical AI practices safeguards data integrity and trust, ensuring responsible deployment across all operations. This approach not only enhances customer experiences but also supports strategic initiatives like fraud detection and personalized product offerings, solidifying Allianz Partners' position as a leader in the insurance sector.
 
 
 81880 | Finance &amp; Accounting | Professional | Non-Executive | Allianz Partners | Full-Time | Permanent
 
 
 Allianz Group is one of the most trusted insurance and asset management companies in the world. Caring for our employees, their ambitions, dreams and challenges, is what makes us a unique employer. Together we can build an environment where everyone feels empowered and has the confidence to explore, to grow and to shape a better future for our customers and the world around us.
 
 
 At Allianz, we stand for unity: we believe that a united world is a more prosperous world, and we are dedicated to consistently advocating for equal opportunities for all. And the foundation for this is our inclusive workplace, where people and performance both matter, and nurtures a culture grounded in integrity, fairness, inclusion and trust.
 
 
 We therefore welcome applications regardless of ethnicity or cultural background, age, gender, nationality, religion, social class, disability or sexual orientation, or any other characteristics protected under applicable local laws and regulations.
 
 
 
 Great to have you on board.
 
 Let's care for tomorrow.
</div>

Finance - Claims Payment Processor & Reconciliation-Ops

WHEALTH INTERNATIONAL L.L.C

<ul><li>Analyze medical claims for accuracy, ensuring all details align with provided documentation and coding guidelines.</li><li>Investigate and resolve claim discrepancies, contacting providers and patients to gather necessary information and clarify issues.</li><li>Process claims efficiently using specialized software, meeting daily processing targets and maintaining a high level of accuracy.</li><li>Verify patient eligibility for benefits, confirming coverage details and communicating any limitations to relevant parties.</li></ul>

Medical Claims Processor

Sara Medical Center

.1 Coordinating with insurance companies for obtaining information on new policies and their coverage.1.2 Verification of insurance eligibility, ensuring coverage of claims, guiding staff for correct use age of claim forms.1.3 Explaining coverage of medical benefits to patients when required.1.4 Assisting invoicing department in insurance processing and billing.1.5 Obtaining approvals for surgeries, medical procedures, and investigations as per different insurance policies using proper CPT &amp; ICD coding.1.6 Entering prescribed medicines to E-Rx as per DHA guidelines and providing E-Rx Reference number to patients prior to discharge.1.7 Encoding claims data into E-claims system while interpreting coding and understanding medical terminology in relation to diagnoses and procedures with correct ICD, CPT, DDC &amp; HCPCS Codes as per DHA guidelines on a timely manner.1.8 Evaluating medical claims encoded in E-claims prior to submission to minimize rejection rate.1.9 Submitting the medical claims in a timely manner to each insurance company and/or Third-Party Administrators (TPA) in a timely manner.1.10 Liaising with insurance companies regarding payment follow-up, resubmission, reconciliation and other requirements.1.11 Allocating payments received from different insurance companies to the company&rsquo;s Statement of Account.1.12 Updating &amp; Analyzing company&rsquo;s Insurance Statement of Account to diagnose weak areas in a systematic way and facilitate proper management.1.13 To train and educate staff in insurance matters &amp; to advise the management on insurance matters.1.14 To maintain and update records related to pre-approvals and reconciliation.1.15 To coordinate and cooperate with colleagues of the same department and other related departments for smooth running of Insurance operations.Application Question(s):<ul><li>Are you a certified Medical Coder?</li><li>Do you have knowledge with submission and re-submission of claims?</li><li>Do you have knowledge in Dental claims ?</li><li>Do you have knowledge in ob gyn claims ?</li><li>Do you have knowledge in GP and Pediatrician claims ?</li></ul>Experience:<ul><li>up: 2 years (Required)</li></ul>Job Type: Full-timeExperience:<ul><li>SUBMISSION ,RESUBMISSION AND RECONMEDICAL IN UAE: 1 year (Required)</li><li>CPT CODES AND ICD CODES: 1 year (Required)</li></ul>

Certified Medical Coder

NMC healthcare LLC

<h2>Job Description</h2>The Insurance Approval Officer is responsible for managing and processing insurance claims, ensuring approval for medications and treatments prescribed by healthcare professionals in the pharmacy department. This role involves coordinating with insurance providers, pharmacists, and healthcare teams to facilitate prompt approvals for patients’ prescriptions, ensuring compliance with insurance policies, and enhancing the patient care experience.<h2>Responsibilities</h2>Insurance Verification: Verify patient insurance details and coverage for prescribed medications and treatments.Claims Processing: Prepare and submit insurance claims for medication approvals, ensuring accuracy and compliance with insurance guidelines.Authorization Requests: Communicate with insurance companies to request prior authorizations for medications and treatments, providing necessary documentation.Follow-Up: Follow up with insurance providers on pending approvals, denials, or requests for additional information.Patient Communication: Inform patients and healthcare providers of the status of insurance approvals or denials, and assist in finding alternative solutions if necessary.Documentation: Maintain detailed records of insurance communications, approvals, and rejections for compliance and reporting purposes.Collaboration: Work closely with pharmacists, healthcare providers, and insurance representatives to resolve issues related to medication approvals.Policy Knowledge: Stay up to date with insurance policy changes, formulary updates, and regulatory requirements related to pharmacy services.Appeals Management: Assist in the preparation and submission of appeal documentation for denied claims and work with insurance providers to resolve issues.<h2></h2>

Officer - Insurance Approval

Interactive Insurance Brokers LLC

An insurance brokerage firm in Dubai is seeking a Claims Operations Supervisor for Pet Insurance to manage claims processing and oversee departmental operations. The ideal candidate will have veterinary clinic experience, excellent communication skills, and a strong customer service orientation. Responsibilities include educating pet owners, managing the claims process, and training sales teams on pet insurance products.

Pet Insurance Claims Operations Leader - Dubai

Allianz

SUMMARY The Medical Claims Officer will provide quality service to clients, promptly and effectively assesses and process claims and approval according to operations set standards. MAIN TASKS   Manages routine daily claims administration work.   Coordinates work flow &amp; meet deadlines.   Evaluates claims with regards to eligibility.   Takes decisions on high cost and complicated cases based on standard operating procedures.   Handles International Preauthorization cases as required.   Attends cal SUMMARY The Medical Claims Officer will provide quality service to clients, promptly and effectively assesses and process claims and approval according to operations set standards. MAIN TASKS   Manages routine daily claims administration work.   Coordinates work flow &amp; meet deadlines.   Evaluates claims with regards to eligibility.   Takes decisions on high cost and complicated cases based on standard operating procedures.   Handles International Preauthorization cases as required.   Attends calls and e-mails from insurance companies, clients, and providers.   Coordinates with international providers for direct billing.   Makes suggestions to improve service.   Increases efficiency, minimizes errors and administration time. BEHAVIORAL REQUIREMENTS   Organizational &amp; time management skills.   Excellent team player.   Ability to work well with all levels of internal management and staff, as well as outside clients and users.   Ability to demonstrate sound work ethics.   Show flexibility with excellent interpersonal skills.   The ability to communicate sensitively and effectively with claims department and other departments having regard for the strict need for confidentiality.   To be capable of responding diplomatically to pressures and problems showing a calm approach to working towards deadlines and always able to show an innovative and creative approach to work.   The ability to exercise initiatives and be able to work flexibly under pressure and to tight deadlines.   Experience of working with senior managers and understanding the necessity to act in a pleasant and courteous manner and to be able to work effectively with others. BEHAVIORAL COMPETENCY Customer &amp; Market Excellence:   Strive for excellence at every touch point with the customer   Foster state-of-art technical/operational knowledge and strive for continuous simplification   Be the benchmark Collaborative Leadership:   Empower the team and provide purpose and direction   Develop people, provide feedback and care to employee wellbeing   Collaborate and exchange best practice. Entrepreneurship:   Act on opportunities, anticipate trends, take risk, and promote a culture that allows for honest failure   Take ownership and responsibility   Embrace innovation and a culture that allows to make decisions without fear of retribution. Trust:   Act with integrity, honor commitments, tell the truth   Foster diversity and inclusiveness   Act transparently and promote corporate social responsibility. MINIMUM REQUIREMENTS   Bachelor's of Medicine (MBBS) only.   Medical Practical Experience (reputable insurance provider, broker or a TPA experience a plus).   Physically fit to carry out duties.   Legally permitted to work in the country of operations.   Fluency in MS Office (Excel, Word, Outlook, PowerPoint) and general internet navigation and research skills 44265 | Operations | Professional | ((custPositionClusterCSB)) | Allianz Partners | Full-Time | Permanent Allianz Group is one of the most trusted insurance and asset management companies in the world. Caring for our employees, their ambitions, dreams and challenges, is what makes us a unique employer. Together we can build an environment where everyone feels empowered and has the confidence to explore, to grow and to shape a better future for our customers and the world around us. We at Allianz believe in a diverse and inclusive workforce and are proud to be an equal opportunity employer. We encourage you to bring your whole self to work, no matter where you are from, what you look like, who you love or what you believe in. We therefore welcome applications regardless of ethnicity or cultural background, age, gender, nationality, religion, disability or sexual orientation. Great to have you on board. Let's care for tomorrow.

Medical Claims Officer

SIDC

Hiring Dental Insurance Clerk (1)Work Location: Abu Dhabi, Western RegionKey Responsibilities:<ul><li>Coordinate with third-party insurance companies to obtain pre-authorization and claim approvals for dental procedures.</li><li>Verify patient insurance coverage and eligibility for dental services.</li><li>Review treatment plans and submit accurate insurance pre-approvals.</li><li>Communicate effectively with patients, dentists, and insurance providers regarding coverage and claims.</li><li>Maintain accurate records of insurance correspondence, approvals, and denials.</li><li>Assist in resolving insurance-related inquiries or discrepancies.</li></ul>Requirements:<ul><li>Proven experience in dental insurance processing or healthcare administration.</li><li>Strong knowledge of dental procedure coding (CDT) and terminology.</li><li>Familiarity with insurance policies, pre-authorization procedures, and claims submission.</li><li>Excellent organizational and communication skills.</li><li>Attention to detail and ability to handle confidential patient information professionally.</li><li>Proficiency in Microsoft Office and dental practice management software.</li></ul>Preferred:<ul><li>Experience working in a dental clinic or hospital setting in Abu Dhabi.</li></ul>Job Type: Full-timePay: AED2,500.00 - AED3,000.00 per month

Dental Insurance Clerk for Western Region Branch

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