Network Coordinator - TPA

Job description / Role

• Provider detailing entry in system (i.e. address, contacts, groupings, currency reference, e-claim code mapping and discount structuring if required)
• Allocations of provider id’s (in net) & (out net) providers
• Provider Specialty updates
• Provider Business information updates including
• Regular maintenance on Provider information
• Initiate updating for any changes i.e. termination, suspension existing providers process linking & delinking of networks and providers time to time update of data whenever is necessary
• Daily clinician report downloads for clinician validation tat of 24-48hr
• Provider Clinician update, review validation and maintenances.
• Responsible in maintenances of provider folders for contracts ,correspondences and commercial terms and changes
• Utilized as reference in giving easy referral to members or clients for a type of doctors field and specialization available Network.
• Responsible for regular audits on provider licensure and to ensure provider license details are up to date which is inclusive of provider communication and timely system updates across UAE and GCC providers.
• Responsible for provider tracking sheets, the providers tracking play important rule as it been utilized by the entire organization, as reference in sending claims rejection, denial, payment report, broadcast, circulars, memos and other correspondence, this tracking as it contain the providers ID’s, providers grouping, contact persons details, appropriate email ID and or important focal points providers.

Salary:
AED 5,000 to 5,500 per month inclusive of fixed allowances.
Additional benefits: Annual ticket, medical and life insurance

Requirements

• University degree in any discipline of medical/Para medical science from a reputable university.
• Basic industry knowledge (healthcare / insurance).
• Should be a team player with an aptitude for customer service.
• Excellent oral and written communication skills.
• Must be computer literate.
• Excellent command of the English language, Arabic is a plus.
• Candidate must be tactful and discrete when dealing with clients and must be able to handle confidential information.
• Ability to work under pressure.
• 2+ years’ experience in the healthcare industry / hospitals is preferable but not mandatory.

About the Company

One of the leading “TPA” , Third Party Administrators in Medical Insurance ; a subsidiary of a fortune 20 Multi National Company , with extensive operation across GCC prospering over the last 18 years in facilitating our customers beyond their expectations in all services on par with global standards.

We are committed in ensuring to provide high quality , superior, innovative and cost-effective business solutions in the areas of healthcare and insurance services and embrace the good will of being one among the best leading TPA’s in this region serving over 50 insurance companies , in administering their multiple policies as well as catering to self-funded schemes with both international and local policies amidst our stake holders.

It is significant to share our accolades, that we serve more than 1.4 million members whilst administering over AED 4 billion worth of claims annually through a dedicated team of 700 + medical professionals in our talent pool from different parts of the world. We are partnered with a broad global network of over 4,000 health care providers in the region and always thrive to delight our customer through every service we provide remarkably.

We believe in attracting dynamic , focused , self-motivated , professionals with industry expertise to join hands with us to move forward in a journey, which promises growth and career establishment as per each one’s skills and potential.