
Claims Executive Healthcare Professional
6 days ago
GIG Gulf is a leading regional composite insurer in the Middle East and North Africa, with presence in 13 markets.
We are seeking an experienced DB Claims Executive to join our team, responsible for contributing to the smooth and efficient processing of claims.
The ideal candidate will have excellent communication skills, both written and verbal, and possess a medical education degree (Physician or Dental).
Key Responsibilities:
- Team Management: Oversee and manage the team in claims processing and communication.
- Claims Processing: Review complex or high-value claims, taking decisions on claims settlements.
- Communications: Communicate with providers and other departments through emails and phone calls.
- Training and Development: Train new team members and provide ongoing training to existing staff.
Operational & Technical Responsibilities:
- Oversee the claims processing workflow, coordinating the workflow within the direct billing claims department.
- Ensure the accuracy and quality of claims processing within the team.
- Evaluate claims based on policy terms and conditions, medical necessity, and coding guidelines.
Role Requirements:
- Due to regulatory requirements, ONLY Omani nationals will be considered for this role.
- Medical education degree is required (Physician or Dental).
- Very good communication skills.
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