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Medical Reimbursement Claims Executive - Fresh Graduates ***ONLY Emiratis with family book***

GIG Gulf
Dubai, UAE
Full Time
Entry
1 months ago
Claims ProcessingMedical TerminologyComputer SkillsCustomer Service
Free

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Claims ProcessingMedical TerminologyComputer Skills
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Job Purpose

  • To process insurance claims in a timely and accurate manner in accordance with Claim’s policy.
  • To respond to and liaise as required with GIG policy holders, insurance brokers and network providers in a professional and courteous manner.

Key Responsibilities

  • Process claims following defined procedures and in accordance with the conditions & terms of the policies.
  • Handle relationships with Members by asking for additional information, explaining settlements, and justifying rejections.
  • Process claims within a reasonable time frame within SLA.
  • Minimize conflicts with members while applying policy terms and conditions.
  • Reject claims lately declared by clients as per Policy Wording.
  • Approve claims within authority limits and refer cases to Manager for approval when exceeded.
  • Process claims as per claims guidelines.
  • Keep all files & information confidential.

Essential Requirements

  • The role requires little independent thought or judgment acting within well defined policies and procedures.
  • Problems are routine/basic in nature; complex issues referred to senior staff.
  • Works under close supervision within defined Claims policies and operating procedures.
  • Nonstandard issues beyond authority levels referred to next level management.
  • Nursing/Healthcare/Pharmacy background preferred.

Operational & Technical Responsibilities

  • Basic understanding of related areas such as accounts/billing.
  • Broad knowledge of GIG Insurance policies.
  • General understanding of Branch structure and policy setups.
  • Basic knowledge of insurance industry.
  • Basic medical terminology and computer handling skills.

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