Medical Claims/Approval Officer at SOS HR Solutions – Al Kuwait

Job Description

Obtains and processes the information needed from insured or designated persons to fulfill medical insurance claims and resolve billing issues. Determines insurance coverage; examines and resolves medical claims; adheres to hospital policy of delivering quality customer service, documents actions and ensures legal and hospital compliance throughout the entire claims process.Job Responsibilities:• Verifies the received insurance claims & related documents from reception or billing clerk.• Verifies all information mentioned in the claim (services/treatments with the given diagnosis, coverage and exclusions)• Communicates with all doctors regarding missing required information or filling mistakes or rejection details and the cause.• Verifies the rejection and prepare the required preventive action plans.• Updates doctors about the Insurance Exclusions & Policies on a regular basis.• Prepares report of the medical errors of the claims or other reports/statements as and when needed.• Checks documents and registration status and maintains departmental records and files.• Documents medical claims actions by completing forms, reports, logs, and records.• Reviews and completes insurance-claim forms and related documents daily• Answers any inquiries regarding insurance claims, missing documents, error corrections status.• Protects operations by keeping claims information confidential.• Adheres to all hospital policies, procedures and guidelines in addition to insurance regulations.


Job Requirements: Education and Experience
• Bachelor University Degree in Medicine (MBBS) is required.• 3 to 5 years of experience working in the medical/Insurance field.
Job-Specific/Technical Skills• Knowledge of basic medical insurance claim/Approval forms and procedures.• Excellent computer skills.• Ability to establish and maintain an effective working relationship with the treating physician.• Strong attention to detail and good analytical skills• Exceptional written and oral communication skills• Good decision-making skills• Critical Thinking• Multitasking• Process review skills• Excellent interpersonal skills Other Preferences• Female/Male• Local candidates with valid and transferable visa in Kuwait

Job Details

Job Location
Al Kuwait, Kuwait

Company Industry
Insurance & TPA

Company Type
Recruitment Agency

Job Role
Medical, Healthcare, and Nursing

Employment Type

Monthly Salary Range

Number of Vacancies

Preferred Candidate

Career Level
Mid Career

Years of Experience
Min: 3 Max: 7

Residence Location


Bachelor’s degree / higher diploma

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