Job Position – OP Claim Officer
Company Name – Almadallah Healthcare Management
Location: Dubai
The OP Claim Officer is responsible for processing and managing operational insurance claims efficiently and accurately. The role involves verifying claim documents, assessing claim validity, coordinating with clients and service providers, and ensuring timely settlement of claims in accordance with company policies and regulatory guidelines.
Key Responsibilities:
Review and process insurance claims submitted by clients.
Verify claim documentation and ensure completeness and accuracy.
Assess the validity of claims by analyzing policy details and supporting evidence.
Coordinate with clients, surveyors, hospitals, or service providers to gather necessary information.
Calculate claim amounts and prepare claim settlement reports.
Ensure compliance with internal policies and regulatory requirements.
Maintain accurate records of all claims processed.
Follow up on pending claims and resolve discrepancies.
Provide excellent customer service by addressing client inquiries related to claims.
Prepare reports on claim trends and recommend improvements in claim processing.
Skills & Qualifications:
Bachelor's degree in Insurance, Business Administration, or related field.
Prior experience in insurance claim processing is preferred.
Good understanding of insurance policies and procedures.
Strong analytical and decision-making skills.
Excellent communication and interpersonal skills.
Attention to detail and accuracy.
Proficiency in MS Office and claim management software.