Dubai - · Audit, evaluate, process, and validate claims with regards to eligibility as per company terms and condition. · Communicate policy and rules to claims evaluation team . Monitor Claims inflow-outflow on a regular basis and make necessary arrangements for TAT to be maintained. . Audit quality of Claims evaluated and collate information for training purposes. . Monitor and participate in quality control reviews · Increase efficiency, minimizing errors and administration time. · Deal with urgent and non-urgent situations involving insured members, families, insurance companies, agents, hospital personnel and the company. · Provide individualized, administrative service and assists insured members in obtaining high quality, cost-effective healthcare services · Perform autonomous duties including claims coverage decision requiring specialized knowledge, judgment and skill within the guidelines of the company · Responsible and accountable for the confidential, proper admin...
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