Medical Claims Operations

**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...

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...

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; -...

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...

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...

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...

**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...

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...

To maintain the continuous improvement system and processes by identifying and developing improvement targets for all areas of the department to achieve operational efficiency, productivity and savings target Process Enhancements - Develop claims management policy, processes and procedures (Standard Operating Procedures SOP) to be used as reference and for...

To maintain the continuous improvement system and processes by identifying and developing improvement targets for all areas of the department to achieve operational efficiency, productivity and savings targetProcess Enhancements Develop claims management policy, processes and procedures (Standard Operating Procedures SOP) to be used as reference and for...

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. -...

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...

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...

Job Description:Parsons is looking for an amazingly talented Director - Contracts & Claims to join our team In this role you will get to ensure the project adheres to legal, regulatory standards, and best practices in contract management, serving as a cornerstone of the project's success by safeguarding its commercial integrity. This role reports to the...

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...

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,...

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,...

Medical Device Distribution is Now Hiring Sales Person inSaudi Arabia 0 share IMG Company - Medical Device Distribution Company Required Experience - 5 Years Salary - Not Mentioned Job Description Designation: Sales & Clinical Application Specialist – Cardiovascular Industry Type: Medical/ Hospital/ Healthcare Job Period: Full Time Requirements: ...