Medical Claims Assessor
Current• Giving approvals for inpatient & outpatient.• Provide Written approval through emails, and computer generated system• Managing the calls related to the approvals.• Enter patient’s complaints and diagnosis.• Highly capable of multi –tasking on a limited time scale• Fixing appointments for the clients with the international hospitals in the list provided by the insurance company• Settling the Claim for reimbursement & direct billing.• Solution finding oriented• Possess problem solving techniques• Ability to work under pressure and meet deadlines• Excellent follow up and organizational skills.• Be client oriented : listening and understanding to clients’ requests / ability to establish good work relationships matching our clients’ needs• Positive attitude when confronted to change• Attention to details and an observant of protocol and internal standards• Review pending and denied claims submitted by providers for re-evaluation• Provide actual decisions for approval and denial in due time.• Providing quality customer service to members, providers, and other insurance companies.• Incase support is needed assisting with Aetna TAD Cases with entries.• Bilingual (Arabic and English): coordinating with the clients in both the languages when needed.