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Specialist, Medical Audit at Daman

Abu Dhabi, Abu Dhabi, United Arab Emirates -

Full Time

Start Date

Immediate

Expiry Date

09 Jun, 26

Salary

0.0

Posted On

11 Mar, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Medical Auditing, Fraud Investigation, Claims Management, Healthcare Compliance, Policy Analysis, Regulatory Compliance, Cost Efficiency, Reimbursement Processes, Data Analysis, Medical Claims, Healthcare Management, Insurance, Risk Management, Public Health

Industry

Insurance

Description

To facilitate and execute medical investigation and audit activities by analyzing medical claims, detecting potential fraud, waste, and abuse, and ensuring compliance with policies, regulations, and best practices in healthcare auditing to optimize cost efficiency and uphold the integrity of Daman’s medical reimbursement processes. The National Insurance Company – Daman The National Insurance Company – Daman is the UAE’s leading health insurer, providing comprehensive health insurance solutions to more than 3 million members in the UAE. Daman is part of PureHealth, the UAE's largest integrated healthcare platform with an ecosystem that changes lifespans and reimagines health spans with 28+ hospitals, 100+ clinics, multiple diagnostic centres, insurance solutions, pharmacies, health tech, procurement, investments and more. Daman, a pioneer in health care insurance, drives innovation through a combination of state-of-the-art technology and healthcare-related expertise offered by a highly skilled and knowledgeable workforce. Members benefit from added value through unique offerings such as the Disease Management Programmes. Daman provides a 24/7 customer call centre and medical services authorisation team who are in direct contact with Daman’s network of over 3,000 medical facilities. The company also provides a diverse range of digital services that are unmatched in the UAE. Daman has set high standards in the health insurance industry and has been awarded a number of internationally recognised awards and quality-focused certifications in a relatively short span of time.

Responsibilities

Facilitate and execute medical investigation and audit activities by analyzing medical claims to detect potential fraud, waste, and abuse. Ensure compliance with policies, regulations, and best practices to optimize cost efficiency and uphold the integrity of medical reimbursement processes.