Medical Claims Officer
Gulf Insurance Group
Total years of experience :3 years, 1 Months
1) Audit the following claims under all Major Policies including AFYA, KPC, EQUATE & FAY.
2) Further analyze Claims and cooperate with the auditing team in Jordan for Quality check purposes.
3) Reconciliation of rejected claim amounts on multiple grounds such as incompletion in the documentation, wrongly submitted claim or policy exclusion.
4) Assessing fraudulently submitted claims in order to proceed with clearance.
5) Assigning claims to medical advisors in order to proceed with the settlements.
6) Reimbursement of insured members for medical services availed abroad or within Kuwait provided they submit proper documentation.
7)Process the TPA claims for the insured members of Globemed.
8) Government consigns the settlements to investigate AFYA claims of insured government official “dead members” and cooperate with Ministry of Health (MOH).
9) Providing the providers with their following cheque details of the payment.
1) Assisting the Agent with Day to day Activities related to Air Ticketing.
