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قام 467 شخص بالتقدم الى الوظيفة

إنتهت صلاحية هذا الإعلان الوظيفي لقد إنتهت صلاحية هذا الإعلان الوظيفي و هو غير مفتوح حاليا لأي طلبات عمل.


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تاريخ إنشاء الإعلان: 2015/06/03 11:13:37
الرقم المرجعي JB1001846655

National Health Insurance Company - Daman

Medical Review Officer (UAE National Only)
National Health Insurance Company - Daman

الوصف الوظيفي

•Evaluate medical necessity and consistency of diagnosis, procedures, drug codes and descriptions stated on the claims according to accepted medical coding rules and guidelines, Ensure accurate application of contractual prices and discounts, schedule of benefits, general exclusions, allocation of benefits, collection of deductibles, co-payments, observance of policy limits, and adherence to claims submission protocols
•Escalate observations about providers’ billing and coding trends to the supervisor. Report fraud and abuse cases to Medical Investigation and Audit Department according to set policies and procedures
•Contribute in developing, updating and implementing the guidelines for evaluation and processing of medical claims, as well as policies and procedures and work instructions related to medical claims review and processing
•Ensure that business decisions and processes are documented in a professional way and the communication requirements are being adhered to in a timely and professional manner
•Deliver high quality customer service and respects medical and work ethics at all times
•Consistently, efficiently and effectively work on achieving the daily targets, quality benchmarks and other key performance indicators (KPIs)


• 1-2 years experience in clinical practice is preferred
• Experience in medical claims/health insurance industry is a plus

تفاصيل الوظيفة

  • منطقة الوظيفة: أبوظبي, الإمارات
  • قطاع الشركة: تأمين
  • المتطلبات : صاحب عمل (القطاع الخاص)
  • الدور الوظيفي: الطب
  • الحالة الوظيفية: دوام كامل
  • نوع التوظيف: دوام كامل
  • يتطلب إدارة موظفين آخرين: لا
  • عدد الوظائف الشاغرة: 2

المرشح المفضل

  • المستوى المهني: متوسط الخبرة
  • عدد سنوات الخبرة : الحد الأدنى: 0 الحد الأقصى: 2
  • منطقة الإقامة: الإمارات العربية المتحدة
  • الجنسية: الإمارات العربية المتحدة
  • الشهادة: بكالوريوس

وصف الشركة

Daman provides affordable quality healthcare solutions to suit your needs
Specialized Health Insurance services with an emphasis on customer care
The market leader with experienced staff that you can rely on.