Company - Adecco Holding Emirates B.V. (Dubai Branch)
Required Experience - 2-8 Years
Location - Dubai - United Arab Emirates
Salary - Not Disclosed
Available Vacancy - 3 Vacancies
Job Description
Designation: Medical Liaison Coordinator
Department: Medical Network & Claims
Functional Area: Doctor/Nurse / Paramedics / Hospital Technicians/ Medical Research
Industry Type: Insurance
Key skills: MBBS,insurance
Responsible for reviewing, analyzing & authorizing services in line with benefits adjudication as per medical and coding guidelines. This includes diagnosis, prescription of medicine, minor operations, inpatient hospital confinement, outpatient surgeries, outpatient laboratory tests, physiotherapy, MRI/ CT scan tests and different treatments for injuries, diseases and other ailments. Authorizing Medical/Surgical Outpatient, Inpatient Cases for insured members by Network Hospitals & Clinics Identifying cases for Case Management of insured members who are confined to a hospital for medical/ surgical management and sending Case Alerts to the Case
Management Unit Participating in Health Wellness Campaigns like I ACT for Diabetic insured members Coordinating with insured members & discussing the treatment plan recommended by treating physicians, as well as initiating, if required, the Second Medical Opinion Process Providing 24/7 Preapprovals Call Support service to insured members
Preparing Savings Report & working towards the Target set by Line Manager
Communicating with the Providers/insured through emails/ telephone regarding preapprovals. Providing support to Providers & Insured on the Pharmacy Management (Program PBM)
Issuing 'Guarantee of Payment letters to non-contracted Providers upon approval by the Line Manager Ensuring that the pre authorisation requests are attended and reverted to within the Stipulated Turnaround Time Ensuring that call abandonment rate does not exceed the target set by Line Manager.
Understand and adhere to all Compliance requirements, including but not limited to, reporting of suspicious transactions, screening requirements, as applicable, and the retention of Company records; plus provide timely support and unrestricted access to information as well as attend all training requests from Compliance.
Desired Candidate Profile
Qualification: MBBS
Candidate Country: Any Nationality
Job period: Contract - 12 months
Work Time: Full Time
Contact Details
Phone: +97143687900
source: naukri gulf