Insurance Claims Operations Expert

17 hours ago


Muscat, Muscat, Oman beBee Careers Full time

About the Role:

This is an exciting opportunity for an experienced Claims Executive to join our team in Omani National role. The successful candidate will be responsible for ensuring the smooth and efficient processing of claims, maintaining compliance with regulations and policies.

Key Accountabilities:

  1. Oversee the claims processing workflow, coordinating the workflow within the direct billing claims department.
  2. Ensure the accuracy and quality of claims processing within the team.
  3. Evaluate claims based on policy terms and conditions, medical necessity, and coding guidelines.
  4. Report potentially fraudulent or suspicious claims and collaborate with relevant departments.
  5. Assist in the evaluation and review of claims rejections.


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