Medical Claims Specialist – Process & Fraud Insight

Joinimagine; Doha; On-site; QAR 67,000 - 100,000; Full time

Job summary

Joinimagine is seeking a Claims Officer in Doha to assess and process medical claims in line with company standards. The role involves supporting team objectives and ensuring adherence to policies, while maintaining high service levels.

The candidate should have MBBS/BDS/Pharmacy/Nursing and 2+ years of medical claims experience, with proficiency in MS Office and the ability to work legally in Qatar.

Qualifications

• Bachelor’s degree in a medical field (MBBS/BDS/Pharmacy/Nursing).
• 2+ years medical claims experience (insurance broker/TPA a plus).
• Physically fit to perform duties.
• Legally permitted to work in Qatar.
• Fluent in MS Office and general internet navigation.

Responsibilities

• Evaluates medical claims from technical and medical perspectives per policy terms.
• Channels claims officers to handle difficult cases and optimize output.
• Checks if treatment plans are necessary for patients.
• Analyzes fraud, waste and abuse patterns and trends.
• Provides clients an understanding of declined medical claims.
• Maintains daily productivity targets and service levels.
• Manages routine daily claims administration work.
• Coordinates workflow and meets deadlines.

Skills

Medical experience

MS Office

Education

MBBS / BDS / Pharmacy / Nursing

Tools

MS Office

Job description

Joinimagine is seeking a Claims Officer in Doha to assess and process medical claims in line with company standards. The role involves supporting team objectives and ensuring adherence to policies, while maintaining high service levels.

The candidate should have MBBS/BDS/Pharmacy/Nursing and 2+ years of medical claims experience, with proficiency in MS Office and the ability to work legally in Qatar.