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    Insurance Claims Specialist - Doha, دولة قطر - alfardan group

    alfardan group
    alfardan group Doha, دولة قطر

    منذ أسبوع

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    Position Summary:

    The Insurance ClaimsSpecialist reflects the mission, vision, and values of theorganization, adheres to the organization's Code ofEthics and complies with all relevant policies, procedures,guidelines and all other regulatory and accreditation standards.

    The Insurance Claims Specialist under the direction of the RevenuesCycle Lead will be generally responsible for insurance claimssubmissions and resubmissions (appeal) based on the agreed contractwith each payer in the region.


    Key Role Responsibilities:
    Theposition holder will be responsible for the below: SUBMISSIONS:

    • Reviews accuracy and completeness of informationrequested and ensure that all supporting documents are present
    • Receives requests for pre-authorizations and ensure thatthey are properly and closely monitored
    • Consults withsupervisor or nurse manager to obtain clearance that treatmentregimen is considered a medical necessity
    • Processesreferrals and submit medical records to insurance carriers toexpedite prior authorization processes
    • Managescorrespondence with insurance companies, physicians, specialistsand patients as required
    • Looks through denials andsubmit appeals in a bid to get them approved from insurancecompanies
    • Creates
  • alfardan group

    Insurance Claims Specialist

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