Operations Support & Transformation (quality & Control)
Dubai, United Arab Emirates
Job Description
What you do
The Quality Assurance Specialist \xe2\x80\x93 Closed File Review is responsible for activities concerned with review and inspection to apply quality standards for operational processes
Your main tasks:
- Prepare concise documentation and audit reports, including recommendations to claims management for improvements with corrective action plans;
- Audit, assess, and monitor providers and payers, to include but not limited to physicians, inpatient, outpatient, ancillary, behavioral healthcare, laboratory, etc. medical records, and independently codes, and abstracts.
- Analyze inpatient and outpatient medical records using most current International Classification of Diseases (ICD-9/ICD-10),Current Procedural Terminology (CPT), Health Care Common Procedure Coding System (HCPCS), Universal Billing (UB) and other codes, regulatory and contractual requirements, and generally accepted coding practices.
- Verify and validate claims documents received through multiple channels to rule out possibility of documentation / coding errors or other inconsistencies that may occur in case of suspected fraud and abuse cases.
What you bring
38802 | Operations | Professional | Non-Executive | Allianz Partners | Full-Time | Permanent
- Bachelors Degree (Medical Degree or Nursing)
- Minimum 5 years\xe2\x80\x99 experience from Providers/TPA\xe2\x80\x99s in processing/adjusting claims (e.g. ICD-9/10, CPT, HCPC)
- Demonstrated understanding of medical claims processes and procedures, and ability to recognize and interpret variances
- Legally permitted to work in the country of operations. Fluency in MS Office (Excel, Word, Outlook, PowerPoint) and general internet navigation and research skills
38802 | Operations | Professional | Non-Executive | Allianz Partners | Full-Time | Permanent
Allianz Group is one of the most trusted insurance and asset management companies in the world. Caring for our employees, their ambitions, dreams and challenges, is what makes us a unique employer. Together we can build an environment where everyone feels empowered and has the confidence to explore, to grow and to shape a better future for our customers and the world around us.
We at Allianz believe in a diverse and inclusive workforce and are proud to be an equal opportunity employer. We encourage you to bring your whole self to work, no matter where you are from, what you look like, who you love or what you believe in.
We therefore welcome applications regardless of ethnicity or cultural background, age, gender, nationality, religion, disability or sexual orientation.
Great to have you on board. Let\'s care for tomorrow.
Note: Diversity of minds is an integral part of Allianz\xe2\x80\x99 company culture. One means to achieve diverse teams is a regular rotation of Allianz Executive employees across functions, Allianz entities and geographies. Therefore, the company encourages its employees to have motivation in gaining varied skills from different positions and to collect experiences from across Allianz Group.
We at Allianz believe in a diverse and inclusive workforce and are proud to be an equal opportunity employer. We encourage you to bring your whole self to work, no matter where you are from, what you look like, who you love or what you believe in.
We therefore welcome applications regardless of ethnicity or cultural background, age, gender, nationality, religion, disability or sexual orientation.
Great to have you on board. Let\'s care for tomorrow.
Note: Diversity of minds is an integral part of Allianz\xe2\x80\x99 company culture. One means to achieve diverse teams is a regular rotation of Allianz Executive employees across functions, Allianz entities and geographies. Therefore, the company encourages its employees to have motivation in gaining varied skills from different positions and to collect experiences from across Allianz Group.
Job Level:
Professional
Location:
Dubai, AE
Area of Expertise:
Operations
Unit:
Allianz Partners
Employing Entity:
NEXTCARE Claims Management LLC
Job Type:
Full-Time
Remote Job:
Not applicable
Employment Type:
Permanent
ID:
38802
Position Cluster:
Non-Executive
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Job Detail
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Job IdJD1627971
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IndustryNot mentioned
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Total Positions1
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Job Type:Full Time
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Salary:Not mentioned
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Employment StatusPermanent
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Job LocationDubai, United Arab Emirates
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EducationNot mentioned