Medical Officer
Qatar Insurance Company
Total years of experience :7 years, 5 Months
Qatar Insurance Company, Dubai, UAE.
Medical Officer (February 2010 - till date)
Maintaining detailed knowledge of new and existing products by liaising with colleagues;
Developing and maintaining good working relationships with clients, primarily Insurance
Brokers.
➢ Planning of daily work schedule of the claims processing in my department.
➢ Reporting to the Manager regarding the claims statistics (TAT) of Network claims and for reimbursement claims.
➢ Administration and correspondences regards to claims with TPA's, insured groups, brokers and individuals.
➢ Approving in-patient medical cases with help of Third party administrators.
➢ Advising and answering queries from different participating companies and individuals.
➢ Handling reconciliation of claims on daily basis.
➢ Claims analysis of groups on quarterly basis and forwarding the same to the client.
➢ Providing the Manager with the loss ratio of the group in coordination with the underwriting department in order to facilitate the renewal terms submission.
➢ Answering queries about the policies to both clients and brokers.
➢ Well versed knowledge about HAAD regulations and implementations.
➢ Attending regular meetings with the direct clients and TPA's in order to maintain the proper service level agreements (SLA)
➢ Attending meetings with HAAD along with TPA in case of any discrepancies in the claim settlement or approvals/denials
Maintaining detailed knowledge of new and existing products by liaising with colleagues;
Developing and maintaining good working relationships with clients, primarily Insurance
Brokers.
Planning of daily work schedule of the claims processing in my department.
Reporting to the Manager regarding the claims statistics (TAT) of Network claims and for reimbursement claims.
Administration and correspondences regards to claims with TPA’s, insured groups, brokers and individuals.
Approving in-patient medical cases with help of Third party administrators.
Advising and answering queries from different participating companies and individuals.
Handling reconciliation of claims on daily basis.
Claims analysis of groups on quarterly basis and forwarding the same to the client.
Providing the Manager with the loss ratio of the group in coordination with the underwriting department in order to facilitate the renewal terms submission.
Answering queries about the policies to both clients and brokers.
Well versed knowledge about HAAD regulations and implementations.
Attending regular meetings with the direct clients and TPA’s in order to maintain the proper service level agreements (SLA)
Attending meetings with HAAD along with TPA in case of any discrepancies in the claim settlement or approvals/denials
Properly guiding the clients regarding the health instruction in order to reduce the weight and maintain a proper healthy diet.
Attaining the business targets on monthly basis.
VLCC, Dubai, UAE.
Medical Instructor (2008-2010)
➢ Properly guiding the clients regarding the health instruction in order to reduce the weight and maintain a proper healthy diet.
➢ Attaining the business targets on monthly basis.
Forwarding documents to various TPA’s for prior approval of various cases.
Regular follow-ups will be done with the TPA’s to get the approvals on time which will enable the satisfaction of the client.
Reporting to the management regarding the work flow of the department on weekly basis.
Efficient in leading a team of members in order to facilitate the proper work flow in the department.
Dr.Joseph's Polyclinic, Dubai, UAE.
Insurance Co-ordinator (2006-2008)
➢ Forwarding documents to various TPA's for prior approval of various cases.
➢ Regular follow-ups will be done with the TPA's to get the approvals on time which will enable the satisfaction of the client.
➢ Reporting to the management regarding the work flow of the department on weekly basis.
➢ Efficient in leading a team of members in order to facilitate the proper work flow in the department.
Bachelor of Physiotherapy (4 year course +6 month's internship)