Medical Insurance Claiming

Responsible of securing 80% of clinic revenue as its covered under insurance. Managing claiming and billing process internally and externally with excellence. Performs audits on insurance claims to ensure full governance and compliance on the claiming and billing process and raise internal physicians awareness on CCHI and Insurance provider policy including...

To ensure that assigned provider’s Inpatient and Outpatient claims are medically & commercially adjudicated within the specified timeframe and within the targeted quality to achieve the business objective of ensuring that BUPA delivers high quality claim statements. Adjudication - Process all the daily batches of claims assigned in line with medical...

This role will be leading and managing the medical approvals, insurance claiming and Billing process with insurance companies and credit corporate sales accounts. Also working to minimize the rejections and collect payments within due dates to improve polyclinic profitability.Accountabilities Medical Insurance Head Working on instant approvals for insurance...

**Role Purpose** To be fully trained and aware of claims handling process including adjudication & fraud, waste and abuse management. Moreover, ensuring that daily assigned tasks are completed withing the specified time frame in line with Bupa’s values. **Key Accountabilities** - Process all the daily batches of claims assigned in line with medical...

Role PurposeTo be fully trained and aware of claims handling process including adjudication & fraud, waste and abuse management. Moreover, ensuring that daily assigned tasks are completed withing the specified time frame in line with Bupa's values.Key Accountabilities Process all the daily batches of claims assigned in line with medical policy and Outpatient...

MedNet is one of the leading managed care service organizations that caters to healthcare needs and offers protection against unforeseen health risks. We are looking for a Claims Manager who willplan and manage the data entry and claims processing operations of the assigned MedNet in order to ensure the delivery of superior claims handling services to...

Responsible in tabulating KPI for Reception in Daily basis. Reviews \ Rechecks patient's policy number and membership number from the saved eligibility and from the System. Records all reception related reports. Prepare pr secure the excel sheet for the insurance audit team daily review. Secures prior authorization (pre approval) request. Average...

**What is in it for you?** This is a great opportunity to collaborate and work alongside a highly motivated and well-respected team at Marsh. You will also be provided access to colleague resource groups across KSA that provides mentorship and development opportunities to help you build a sense of connection and community throughout your career. **We will...

Responsible in tabulating KPI for Reception in Daily basis.Reviews \ Rechecks patient's policy number and membership number from the saved eligibility and from the System.Records all reception related reports.Prepare pr secure the excel sheet for the insurance audit team daily review.Secures prior authorization (pre approval) request. Average approvals per...

Role Purpose: Perform medical analysis and the inflation drivers from medical point of view, along with underwriting and pricing cases. Key Accountabilities: 1- Medical Underwriting; - Estimate cost of the medical conditions declared under the retail products based on medical reports and test results submitted by the member for new retail business. -...

Powelson Consulting View our Job Board We are a recruiting firm with a large variety of positions in many industries throughout all Our clients are currently only located in the United States of We currently DO NOT have C2C or VISA rolesSummaryPrimary Duties - We are like a mini version of We are like a hub that brings things in, scans the...

Powelson Consulting View our Job Board! We are a recruiting firm with a large variety of positions in many industries throughout all Our clients are currently only located in the United States of We currently DO NOT have C2C or VISA rolesSummaryPrimary Duties - We are like a mini version of We are like a hub that brings things in,...

About the Program: We are excited to offer a training opportunity through Tamheer program for recent graduates. This is an excellent chance to gain hands-on experience and develop your skills in a dynamic and supportive environment. Departments with Vacancies: Claims Underwriting Recovery Key Responsibilities: Claims: Assist in evaluating and processing...

Building Quality Control Models that capture the required transactions in any given stream. - Perform the Quality Control Process: that includes, and not limited to, sampling, validation and releasing the related scorecards across all the functions under the scope of the Medical Quality (Preauthorization, Claims, Re-Imbursement and CS). - Perform all NPS...

Role Purpose: Provider Capability Compliance is a key enabler in order to achieve Bupa Arabia vision. The position plays an important role in driving the execution of identified key projects that supports the Provider Capability Compliance enabler and other key business priorities. Key Accountabilities: 1- Claims Efficiency; - Orient the providers to comply...

Role Purpose: To be responsible for the commercial and medical management of the portfolio providers in order to resolve the identified trends ,unit cost control and obtain competitive commercial terms and reconciliation outcome within the agreed target forecasting ,timescales and quality standards. Key Accountabilities: 1- Reconciliation of the accounts; -...

Role Purpose:Provider Capability Compliance is a key enabler in order to achieve Bupa Arabia vision. The position plays an important role in driving the execution of identified key projects that supports the Provider Capability Compliance enabler and other key business priorities.Key Accountabilities:1- Claims Efficiency; Orient the providers to comply with...

Role Purpose:To be responsible for the commercial and medical management of the portfolio providers in order to resolve the identified trends ,unit cost control and obtain competitive commercial terms and reconciliation outcome within the agreed target forecasting ,timescales and quality standards.Key Accountabilities:1- Reconciliation of the accounts; Set...

Develop and manage the excellence deployment for all payer operation and claim requirements in line with regulator policies and ensure proper collaboration with Nahdi departments to ensure the best outcomes via established SLA & SOPs. **Accountabilities** **Contracting & Benefit File Excellence**: - Ongoing maintenance of all payers contract to comply...

Is responsible for overseeing the RCM operations including claims and billing management. Communicate partner providers, implement and refine processes of audit and compliance, execute special RCM projects and participate in different analytical activities **Claims and billing management** - Develop and maintain a strategic approach to the revenue cycle...