Jobs in Kuwait - career in Kuwait - vacancies in Kuwait-Doctors (Roving/Approvals) - WARBA Insurance-Jobs in Kuwait - career in Kuwait - vacancies in Kuwait
Role Title: Doctor (Roving / Approvals)
Role purpose summary: Monitor the performance of Claims, Pre Authorization, Provider Reconciliation & Fraud detection and take corrective & preventive measures to meet the TAT and set standard.
Key responsibilities and accountabilities:
- Assisting and monitoring & distributing the work between team members in the approval team.
- Monitor the performance of Claims, PreAuthorization,
- Roving & Fraud detection and take corrective & preventive measures to meet the TAT and set standard.
- Send savings report for Management
- Train the Paramedical/ Doctors how to do claims adjustments
- Reconciliation with Providers on a regular basis
- Replying the emails related to approvals/claims queries in addition to the questions received from insurance companies or from members
- HCC, Emergency and VIP approvals management
- Handling claim related Medical queries and clarify auditors inquiries.
- Coordination with the providers’ medical staff for the medical case management
- Coordinate with Network Team to ensure prices are in balance
- Escalate suspected fraud and abuse approvals
Job Details
| Posted Date: | 2018-10-25 |
| Job Location: | Al Kuwait, Kuwait |
| Job Role: | Administration |
| Company Industry: | Insurance |
Preferred Candidate
| Career Level: | Mid Career |
| Degree: | Doctorate |
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Jobs in Kuwait - career in Kuwait - vacancies in Kuwait-Doctors (Roving/Approvals) - WARBA Insurance-Jobs in Kuwait - career in Kuwait - vacancies in Kuwait
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