- Ensuring error free processing of preauthorization within agreed TAT (Turnaround time) by way of following the process.
- Inform providers as needed and file completed precertification requests as per procedures
- Interacting with providers to complete the claim documentation etc. As and when required.
- Ensure the accuracy of all the authorization approval as per the process.
- Any authorization not as per the limit or as per the process to be escalated to the team manager on priority.
- Ensuring process compliance is met as per regulatory procedures.
- Maintaining Daily excel maintenance for Pre-auth cases received and processed.
- Solving customer queries wherever medical opinions are required and need to be address by the medical practitioner.
- Receive and process complaint, request received from customer care
- Detect fraud and raise the suspected cases to the concerned team
- Follow all relevant departmental policies, processes, standard operating procedures and instructions so that work is carried out in a controlled and consistent manner.
- To manage claims and ensure that internal KPI’s are met as per the procedure manual.
Job Type: Full-time
Pay: QAR1.00 per month
Ability to commute/relocate:
- Doha: Reliably commute or planning to relocate before starting work (Required)
Application Question(s):
- Are you comfortable working in Insurance Industry?
Education:
- Bachelor's (Required)