By New Mowasat Hospital, Kuwait Qualification:
- Bachelor’s Degree with Good Knowledge of Medical Terminology, preferably a Medical Doctor General Practitioner
Experience:
- Minimum 3-5 years’ experience in Insurance Claims (Insurance companies ,TPAs, Hospitals)
DUTIES & RESPONSIBILITIES:
- Perform & monitor on a daily basis all medical claims audit assuring treatment provided is in line with insurance policies terms & conditions.
- Ensures that insurance claims are duly completed in accordance to the treatment.
- Notify medical claims falling under general exclusions.
- Prepares monthly reports of claims, Audit’s key indicators with amount of claims individually mentioned. Perform re-submission of claims rejected due to medical reasons.
- Follow up with treating doctors & gets the precise justification to respond back to insurance companies.
- Provide relevant justification reports along with insurance companies queries on case to case basis.
- Maintains, communicates, track and trend audit results and report findings.
- Prepare monthly report of rejected claims resubmission showing the individual cost of claim resubmitted with medical justification. Prompt in identification and communication of recognized errors.
- Provides feedback to Manager, Claims Network and Information System departments of findings to improve quality. Attends meetings as required.
- Perform random quality audits of claims processed.
More Information
- City Kuwait
- Currency Kuwait Dinars – KWD
- Number of Vacancies 1
- Career Level Mid-Career
- Years of experience (Min) 3
- Years of experience End ( Max) 5
- Education Major BS, MBBS
- Preferred Nationality Any Nationality
- Gender Any
- Speciality 1 Insurance claims
