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Officer - Authorization at Munich Re
Suomussalmi, Kainuu, Finland -
Full Time

Start Date

Immediate

Expiry Date

20 May, 26

Salary

0.0

Posted On

19 Feb, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

No

Skills

Medical Claims Evaluation, Authorization, Medical Necessity, Claims Management, Interpersonal Skills, Negotiation Skills, Communication Skills, Analytical Skills, Problem-Solving Skills, Client Centricity, Solution Oriented, Proactive Approach

Industry

Insurance

Description
MedNet Jordan is one of the leading managed care service organizations that caters to healthcare needs. We are currently seeking to hire an Officer – Authorization (on Hybrid working modules basis) with the following tasks and responsibilities: Your Job Medical Claims Evaluation: · Authorization for in-hospital cases in respect of medical necessity and appropriateness. · Evaluation & approval of outpatient claims need authorization in respect to the medical necessity and appropriateness and check them on the system to ensure high quality and correct services. · Chronic soap evaluation, issue, checking, sign & stamp. Business Correspondence · Manage queries from providers, Insurance Companies and insured members relating to authorization, evaluation and administration. · Responding to all international accounts requests and all inquiries from insurance companies. Client Servicing · Deliver excellent customer services to Insurance Companies and insured members with view of achieving maximum client satisfaction. Administrative Services · Medical Updating of the Medical File related to insured members regarding their investigations results like MRI, CT scan, etc.... · Filling of Medical Documents. · Any other tasks assigned by Direct superior /Head of department. Your Profile · Bachelor Degree in Nursing Science, Pharmacy, Paramedical certificate. · From 2 - 4 years' experience in his/her education field. · Experience in claims management in the insurance industry or a TPA/MSO company would be a plus. · Good interpersonal and negotiation skills · Excellent written and verbal communication skills · Analytical and problem-solving skills · Ability to handle stress and work under pressure. · Client Centricity approach · Solution Oriented. · Proactive approach
Responsibilities
The role involves evaluating and authorizing in-hospital and outpatient medical claims based on medical necessity and appropriateness, as well as managing chronic case evaluations. Responsibilities also include handling correspondence and inquiries from providers, insurance companies, and members regarding authorizations and administration.