Medical Reviewer - 2317619

MedNet Global Healthcare Solutions LLC
  • Medical Reviewer Jobs in Muscat - 2317619

    MedNet Global Healthcare Solutions LLC
  • 2 - 3 Years
  • Muscat - Oman
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2317619

Job Description

MedNet Oman is one of the leading managed healthcareservice providers for quality solutions that meet an individual s healthcareneeds We are currently seeking to hire a Medical Reviewer with the followingtasks and responsibilitiesYour Job- Response to pre-authorizations in line with case justification and policy terms and ensure approvalsdenials are issued within set turnaround time- Provide policy benefits awareness to insured members- Communicating the network access modalities to the clients (Internal and external)3- Monthly end-to-end reconciliation closure on medical justification with the providers with an aim to improve practice by treating physician going forward- Analyze any fraud and abuse cases to take necessary precautionary action in co-ordination with network and managed care unit- Support network department on all medical related activities- Medical File Audit for the suspecting cases from the initial claims auditing team- Continuous education to network providers on pre-approval protocol to avoid receiving of non-listed servicesYour Profile- A degree in Medical Field is a must- 2-3 years in a network environment, pre-authorization in the TPAmedical insurance sector preferably in the Gulf region- Knowledge related to updated medical terminology- Industry knowledge related to local healthcare services system- Computer literacy ( MS Office, Excel, PowerPoint)- Oman driving license- Verbal and written communication skills in Arabic is an advantage- Analytical and problem-solving skillsYour ProfileMinimumQualifications University degree in Medical field is a mustMinimum Experience Candidates with 2-3 years of experience in a network environment, pre-authorization in the TPAmedical insurancesector preferably in the Gulf region

Profile Summary

Type:Company Job

Eligibility:Any Graduation.

Industry:Medical / Healthcare / Diagnostics / Medical Devices

Function:Doctor / Nurse / Paramedics / Hospital Technicians / Medical Research

Deadline:20th Apr 2020

Desired Candidate Profile

Medical Reviewer

Company Profile

Not Mentioned



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