Description

Job Description

At Damana Insurance, we are looking for an Emirati national who is interested to join the insurance or continue their career in insurance as a Medical Claims Processor.

The Medical Claims Processor is responsible for claims processing. This includes electronic claims, manual paper claims and reimbursement claims.

Training will be provided for this position.

Key Responsibilities:

• Perform claims data entry and medical review
• Follow pre-approval protocols as per provider handbook.
• Adhere to system driven price list information for financial accuracy of the claims.
• Coordinate with pre-approval team and network team on a case-by-case manner where relevant for the claims adjudication.
• Coordinate with providers in explaining the rejections on claims.
• Assist Team Leader and Operations Manager in enhancing and developing the process and system.
• Adhere to the contents of the Operating Procedures Manual (OPM) and the Company’s overall procedures and policies.
• Miscellaneous tasks within the scope of work, as assigned by the direct manager.

Qualifications:

• Bachelor’s degree/ High School degree