Omani Medical Claims & Pre-Approval Specialist

GIG Gulf; Muscat; On-site; OMR 10,000 - 15,000; Full time

Job summary

A regional insurance provider in Oman seeks a Medical Insurance Processor to assess and evaluate medical claims, ensuring adherence to policies while providing excellent customer service. The ideal candidate will be Omani with a medical degree and experience in insurance processing, capable of handling client inquiries across various channels and contributing to operational excellence. Strong analytical and communication skills are essential for success in this role.

Qualifications

• Omani National.
• 1-2 years’ experience in Medical Insurance Process.
• 6 months to 1 year experience in handling calls.
• Will be required to work in shifts.
• Regional experience and working knowledge of healthcare regulations in Oman.

Responsibilities

• Adjudicate insurance pre-approvals in a timely manner.
• Attend calls from members and providers.
• Process direct billing claims accurately.
• Identify and report potentially fraudulent claims.

Skills

Strong communication (verbal & written)

Medical knowledge and terminology

Analytical skills

Customer-focused

Education

Medical Degree (Medical / Dental / Nursing / Pharmacy / Physiotherapy)

Job description

A regional insurance provider in Oman seeks a Medical Insurance Processor to assess and evaluate medical claims, ensuring adherence to policies while providing excellent customer service. The ideal candidate will be Omani with a medical degree and experience in insurance processing, capable of handling client inquiries across various channels and contributing to operational excellence. Strong analytical and communication skills are essential for success in this role.