MBBS - Medical officer - with TPA & Insurance exp
Job Fit Check
Base Career helps you apply smarter for this job.
Key skills for this role
About the Role
Dubai Insurance TPA is seeking an MBBS Medical Officer with TPA and insurance experience to assist the IP department in medically scrutinizing claims and pre-authorizations. The role requires 2-3 years healthcare industry experience and strong decision-making skills.
Key Skills for This Role
Responsibilities
- Assess day care and in patient cases as per medical justification and policy coverage
- Issue day care and in patient cases within AED 15,000 for medically justified cases
- Respond to payer queries and provide advice on coverage of cases
- Monitor claims cost as per internal guidelines
- Document and report suspected fraud cases
- Maintain claims processing and adjudication cycle in NHS software system
Requirements
- University degree in Medical/Para medical specialization (MBBS, MD, or Nurse)
- 2 3 years experience in healthcare industry/hospitals
- Basic industry knowledge (healthcare/insurance) is a plus
- Excellent oral and written communication skills
- Computer literate
- Excellent command of English; Arabic is a plus
Full Job Posting
Job Purpose
- To assist the IP department in finalizing cases by medically scrutinizing and justifying prescribed treatment or service.
- Maintain IP pre approvals and claims processing within NHS software systems.
Responsibilities and Duties
- Research and follow up on Medical Treatment patterns and conduct utilization reviews.
- Assess day care and in patient cases as per medical justification and policy coverage.
- Issue day care and in patient cases within AED 15,000 for medically justified cases.
- Escalate and confirm grey area cases.
- Respond to payer queries and provide advice on coverage.
- Monitor claims cost as per internal guidelines.
- Reject medically unjustified and policy excluded cases.
- Contact provider for queries and clarifications.
- Document and report suspected fraud cases.
- Maintain claims processing and adjudication cycle in NHS software.
- Take lead role in ensuring team tasks are completed within time frame.
- Achieve required processing targets.
Knowledge, Skills and Experience
- University degree in Medical/Para medical specialization (MBBS, MD, or Nurse).
- 2 3 years experience in healthcare industry/hospitals mandatory.
- Basic industry knowledge (healthcare/insurance) is a plus.
- Team player with aptitude for customer service.
- Highly decisive with outstanding logic and reasoning skills.
- Excellent oral and written communication skills.
- Computer literate.
- Excellent command of English; Arabic is a plus.
- Tactful and discrete when dealing with clients.
- Ability to work under pressure and meet tight deadlines.
Salary
- Pay: AED 9,000 10,000 per month.
Work Location
- In person.
Apply for this job in 1 click
Skip the repetitive application forms
Install the Base Career Chrome Extension and autofill job applications across major job boards with your profile.
Trusted by over 500,000 job seekers on Base Career
More from this employer
More jobs at Dubai Insurance TPA
Data Engineer - Insurance/TPA experience
Dubai, UAE
Dubai Insurance TPA is looking for a Data Engineer to develop, implement, and maintain data management processes and infrastructure. The role requires experience in database design, data security, and managing complex bu
Database Administrator - Insurance/TPA
Dubai, UAE
Dubai Insurance TPA seeks a Database Administrator to manage Oracle and SQL Server databases. The role involves installation, configuration, monitoring, backup, recovery, and security. Requires 3+ years experience, Oracl
Mobile App Developer - Insurance/TPA exp
Dubai, UAE
Dubai Insurance TPA is looking for a Mobile App Developer with at least 3 years of experience in mobile application design and development. The role involves gathering user requirements, writing clean code using Swift, K
Wellness Coach - (Personal Trainer) with corporate and Insurance experience - Female Arabic speaker
Dubai, UAE
Dubai Insurance TPA seeks a Wellness Coach/Personal Trainer to plan and supervise fitness/wellness programs for clients and staff. Requires a Bachelor's degree in health or physical education, 2 years of experience, and
Senior Installation Associate -Account Installation (Insurance TPA)
Dubai, UAE
Dubai Insurance TPA seeks a Senior Installation Associate to manage complex account installations and renewals for large corporate and SME accounts. The role involves defining onboarding plans, tracking milestones, and c
Wellness Coordinator - with Insurance and TPA experience
Dubai Silicon Oasis, UAE
We are seeking a passionate Wellness Coordinator to join our team in Dubai Silicon Oasis. The role involves planning and executing wellness activities for employees and designing wellness programs for external clients. C
Wellness Coordinator
Dubai Silicon Oasis, UAE
Dubai Insurance TPA is seeking a Wellness Coaching Analyst to design and manage wellness programs for both internal employees and external clients. The role involves conducting assessments, coordinating wellness activiti
Manager - Claims & Pre-Authorization
Dubai Silicon Oasis, UAE
Dubai Insurance TPA is seeking a Manager to lead Pre-Authorization and Claims Operations. You will oversee SLA performance, regulatory compliance, quality management, and team development. The ideal candidate has 7-8 yea
Data Engineer - Insurance/TPA experience
Dubai, UAE
Database Administrator - Insurance/TPA
Dubai, UAE
Mobile App Developer - Insurance/TPA exp
Dubai, UAE
Wellness Coach - (Personal Trainer) with corporate and Insurance experience - Female Arabic speaker
Dubai, UAE
Senior Installation Associate -Account Installation (Insurance TPA)
Dubai, UAE
Wellness Coordinator - with Insurance and TPA experience
Dubai Silicon Oasis, UAE
Wellness Coordinator
Dubai Silicon Oasis, UAE
Manager - Claims & Pre-Authorization
Dubai Silicon Oasis, UAE