Duties and responsibilities:

1. provider detailing entry in system (i.e. address, contacts, groupings, currency reference, e-claim code mapping and discount structuring if required)

2. allocations of provider id’s (in net) & (out net) providers

3. Provider Specialty updates

4. Provider Business information updates including

5. Regular maintenance on Provider information

6. initiate updating for any changes i.e. termination, suspension existing providers

7. process linking & delinking of networks and providers

8. time to time update of data whenever is necessary

9. Daily clinician report downloads for clinician validation tat of 24-48hr

10. Provider Clinician update, review validation and maintenances.

A. CLAIM FIXING CLINICIAN

1. Clinician pending to be updated in system follow with provider

2. Update the claims pending on clinicians

Ø PROVIDER FOLDER DATABASE MAINTAINANCE–responsible in maintenances of provider folders for contracts ,correspondences and commercial terms and changes

Ø NEW DOCTORS EMPANELMENT AND LIST MAINTENANCE – utilized as reference in giving easy referral to members or clients for a type of doctors field and specialization available to Network.

1. Doctors list maintenance and send out Request list and update the master file

2. Attending request from provider for the enrollment of new doctors and assist providers to timely submit the list of additional services proposals for the service to be provided by new doctor

3. assessment of doctors eligibility and sent empanelment confirmation and approval

4. updates for termination / suspension

Ø PROVIDER LICENSE CLEAN UP – responsible for regular audits on provider licensure and to ensure provider license details are up to date which is inclusive of provider communication and timely system updates across UAE and GCC providers

Ø PROVIDER TRACKING SHEET – responsible for provider tracking sheets, the providers tracking play important rule as it been utilized by the entire organization, as reference in sending claims rejection, denial, payment report, broadcast, circulars, memos and other correspondence, this tracking as it contain the providers ID’s, providers grouping, contact persons details, appropriate email ID and or important focal points providers.

Job Types: Full-time, Permanent

Pay: AED5,000.00 - AED6,000.00 per month

Ability to commute/relocate:

• Dubai: Reliably commute or planning to relocate before starting work (Required)

Education:

• Bachelor's (Preferred)

Experience:

• Provider Network: 2 years (Preferred)
• medical insurance: 2 years (Preferred)
• TPA: 2 years (Preferred)
• hospital: 1 year (Preferred)

Language:

• English (Preferred)
• Arabic (Preferred)