Job Description
Black & Grey HR is working with one of the largest fully independent TPAs in the Middle East focusing entirely on healthcare benefits management. Our client is actively looking to hire a Medical Officer (MBBS/MD) for its business in Kuwait.
Job Responsibilities:
Assess day care and in-patient cases as per medical justification and policy coverage.
Issuing day care and in-patient cases for medically justified cases in line with the policy.
Escalate and confirm grey-area cases. Confirming of exclusions of borderline cases OP/IP.
Sending request of confirmation and notification to corresponding payers as needed.
Responding to payer’s queries in relation to day-care and Inpatient cases.
Responding to the payer’s request for advice on coverage of cases.
Conformity of assessment for the prescribed tests/medications/investigations/clinical
Contacting provider for queries and clarifications.
Educational Qualification:
Doctor (MBBS degree/ MD degree)
Experience required:
2 – 3 years’ experience in the healthcare industry/hospitals is preferable, but not mandatory
Basic knowledge of healthcare/ insurance industry.
Other requirements:
Should be a team player with a passion for customer service
Must be service oriented
Excellent oral and written communication skills
Must be computer literate.
Excellent command of the English language, Arabic is a plus
Candidates who are currently on Kuwait residence visa / transferable will be preferred.
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