Health Support Associate- Pre-approvals (General Practitioner)
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Key skills for this role
Role Overview
QLM Life and Medical Insurance provides health-insurance services and support to individuals and organizations.
The role seeks a qualified General Practitioner with strong clinical knowledge and an interest in health insurance.
The position processes medical claims and pre-approvals, reviews coverage, evaluates documentation, and supports members and healthcare providers.
Key Skills for This Role
Full Job Posting
Role Overview
QLM Life and Medical Insurance provides health-insurance services and support to individuals and organizations.
The role seeks a qualified General Practitioner with strong clinical knowledge and an interest in health insurance.
The position processes medical claims and pre-approvals, reviews coverage, evaluates documentation, and supports members and healthcare providers.
Key Responsibilities
- Process medical claims and pre-approvals in line with policy terms and service standards.
- Review medical documents, eligibility, and benefit coverage.
- Coordinate with healthcare providers, TPAs, and internal stakeholders.
- Ensure accurate data entry and maintain electronic medical records.
- Handle member and provider inquiries about claims and pre-authorizations.
- Maintain compliance with company policies, regulatory requirements, and data-confidentiality standards.
Requirements
- Bachelor's degree in medicine or a related healthcare field.
- One to five years of experience in medical claims, pre-approvals, or health insurance.
- Good knowledge of medical terminology, CPT/ICD coding, and insurance processes.
- Proficiency in Microsoft Office and computer applications.
- Strong communication, analytical, and time-management skills with attention to detail.
- Ability to work under pressure in a fast-paced environment.
- Arabic speaker; bilingual proficiency is an advantage.
Compensation
- Pay is listed as QAR 1.00 to QAR 2.00 per month.
Work Location
- The role is performed in person.
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