Health Claims & Pre-Auth Specialist — Patient Care

B2C Solutions WLL; Doha; On-site; QAR 78,000 - 145,000; Full time

Job summary

B2C Solutions WLL in Doha is seeking a dedicated medical claims processor to review pre-approvals and authorize or reject requests based on policy terms and patient history. You will apply CPT/ICD/DRG coding knowledge to ensure compliant decisions while managing complex cases, including high-cost approvals and international referrals.

Join a team focused on accuracy and cost containment, interact with members and providers by phone and email, and maintain confidential electronic health records

Qualifications

• Valid OID with Secondment.
• 1–3 years of relevant experience in medical claims processing or similar role.
• Strong knowledge of medical terminology and coding.
• Proficiency in Microsoft Office suite.

Responsibilities

• Process medical claims pre-approvals and review decisions based on policy terms and medical history.
• Apply knowledge of insurance policies, medical codes (CPT/ICD/DRG) to ensure compliant decisions.
• Manage patient cases including high-cost approvals, international referrals, and hospital admissions.
• Provide stellar customer service via phone and email to clarify insurance matters.
• Maintain confidential health records in line with GDPR.
• Work with the team to meet KPIs and Turnaround Time targets.

Skills

Medical terminology

Insurance policy interpretation

Medical coding

MS Office

Education

Bachelor's degree in Medicine or related field

Job description

B2C Solutions WLL in Doha is seeking a dedicated medical claims processor to review pre-approvals and authorize or reject requests based on policy terms and patient history. You will apply CPT/ICD/DRG coding knowledge to ensure compliant decisions while managing complex cases, including high-cost approvals and international referrals.

Join a team focused on accuracy and cost containment, interact with members and providers by phone and email, and maintain confidential electronic health records