Experience

• 

  Insular life assurance co., ltd.

  Oct 1999 - Sept 2002

  Medical officer
• 

  Bupa arabia

  Aug 2002 - now

  Job description:To ensure that the claims process flow in the Medical team is complied with so as to help the department produce the final claims statement as per the laid down timelines.#Key AccountabilitiesKey Activities / Decision Areas1Claims processing· To ensure that the daily targets related to claims processing, are consistently achieved so that the department meets its SLA’s to produce a final statement.· To ensure that the provider statements is prepared as per the acceptable medical standards of quality and consistency.· To ensure that all queries regarding the statements produced are answered· Takes steps within his unit, draws measurable action plans to attain the above and coaches, leads and drives his team for producing the results2Resource Management· Makes sure of availability and efficient utilization of resources to ensure a successful outcome, and devises annual recruitment and vacation plans to ensure smooth operation of the unit· Reports shortage of resources well in time, and plans solutions to curb it.3Provider StatementEvaluation· To analyse various batches of claims to identify unwarranted services and unusual trends in order to highlight areas of rejections· Evaluates the provider statements for medical and technical consisitency .4RecordsManagement· Ensures proper record keeping and monitoring for the production, backlogs, assigned targets· Monitors the DMS adjudication, addresses issues encountered and identifies areas of improvement to enhance the efficiency, accuracy and flexibility.5People Management· Leads team goal setting, manages and constantly reviews team and individual performance and provides regular feedback, coaching and development· Motivates, empowers and enables direct reports by providing the necessary tools and support required to achieve Recruitment Objectives Show less

  • Executive Manager

    Jul 2022 - now

  • Executive Manager

    Jul 2022 - now

  • Manager, Medical Claims Operations

    Aug 2002 - Jul 2022