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Job Description
- Assessing medical reports for day-care and in-patient cases and reviewing course of treatment per medical justification.
- Escalating and confirming questionable treatment plans to Medical Director for confirmation.
- Assisting alarm center coordinators and supervisors in adjudicating medical cases, and rejecting medically unjustified procedures and treatment.
- Monitoring medical expenses of a case as per the average expected case cost on file, and identifying any suspected medical fraud cases.
- Conducting medical discussion with medical facilities regarding cases handled by our company and recording the medical intake to write medical reports if required.
- Being available 24/7 for alarm center coordinator queries regarding in-patient claims.
- Assisting company management with all medical related queries requested by company clients and inclusion in client meetings if required.
Job Requirements
- Medical Doctor (MBBS degree / MD degree)
- 3 - 5 years’ experience in healthcare industry
- Hospital experience is mandatory
- Insurance industry experience is a plus
- Fluency in English and Arabic
- Excellent communication skills.
- Full working knowledge of MS Office
