Medical Advisor job - Goodhealth Worldwide (Middle East) LLC - Dubai, Dubai

 

Company Name	Goodhealth Worldwide (Middle East) LLC jobs
Position Type	Full-Time
Job Location	Dubai, Dubai DXB
Job Posted	February 8, 2008
Experience	2-5 years experience
Source	jobs13.bayt.com

Medical Advisor  

To pre-certify treatment, apply appropriate cost containment measures, co-ordinate local provider direct settlement networks, provide medical expertise on claims, and report and manage worrisome trends. 1. Handle pre-certification of out-patient, day-patient and in-patient treatments employing appropriate cost-management measures, including prospective and concurrent Utilisation Reviews. 2. Liaise with doctors and providers to obtain medical information. 3. Handle medical evacuations. 4. Provide advice for large loss, complex and contested claims and contribute to writing a “Medical Guidelines Manual”. 5. Investigate claims for possible abuse, fraud or medical negligence. 6. Manage the local network of providers and their contracts. 7. Analyse reports to identify trends and improve claims services and costs. 8. Adhere to Best Practice Processes, Service Standards and to all relevant statutory or regulatory requirements, including treating customers fairly and other TCF initiatives. 9. Continually work to improve Best Practice procedures and standards - Excellent Communication Skills - Excellent Track Record ...

Job Details / Apply Now   Save This Job