Medical Claims Specialist - UAE Outsourced Role

Combuzz; Dubai; On-site; AED 57,000 - 77,000; Full time

Benefits offered by this job

Company Benefits

Job summary

Combuzz seeks a qualified Medical Claims Administrator to review, process, and assess medical insurance claims in an outsourced setting within the UAE.

The role prefers candidates with healthcare backgrounds from hospitals, clinics, pharmacies, or healthcare providers. Medical claims/insurance experience is advantageous but not mandatory. Strong accuracy, discretion, and timely processing are essential.

Qualifications

• Qualified healthcare professional (e.g., RN or Pharmacist)
• Experience in hospital/clinic/pharmacy or healthcare provider环境 preferred
• Prior medical claims or health insurance experience is an advantage but not mandatory
• Strong understanding of medical terminology and documentation
• Familiarity with ICD-10, CPT, or similar coding standards a plus

Responsibilities

• Receive, review, and process medical insurance claims submitted by policyholders and providers.
• Review claims against policy terms, coverage limits, and medical necessity criteria.
• Verify accuracy and completeness of claim forms, medical records, invoices, and supporting documents.
• Investigate questionable or incomplete claims by contacting providers for more information.
• Analyze medical records to support claim assessment and decisions.
• Make recommendations on claim approvals, denials, or requests for additional information.
• Ensure timely processing and payment of approved claims.
• Coordinate with finance and third-party administrators as needed.
• Communicate claim status and required actions to stakeholders.
• Maintain accurate records of claims and correspondence.
• Ensure compliance with healthcare regulations and coding standards.

Skills

Medical claims processing

Healthcare industry experience

Attention to detail

Education

Registered Nurse

Pharmacist

Tools

Claims processing software

Job description

Combuzz seeks a qualified Medical Claims Administrator to review, process, and assess medical insurance claims in an outsourced setting within the UAE.

The role prefers candidates with healthcare backgrounds from hospitals, clinics, pharmacies, or healthcare providers. Medical claims/insurance experience is advantageous but not mandatory. Strong accuracy, discretion, and timely processing are essential.