Claims Officer

GlobeMed Gulf Healthcare Solutions has been a leading healthcare benefits management company since launching its operations in UAE in 2013. GlobeMed Gulf Healthcare Solutions is proudly a GlobeMed Group franchisee. With over 33 years of experience, GlobeMed Group has a network of franchisees in 11 countries in the MENA region including United Arab Emirates, Iraq, Lebanon, Saudi Arabia, Kuwait, Qatar, Bahrain, Jordan, Palestine, Egypt and Nigeria.

Job Summary

The Claims Officer handles the auditing and adjustment of claims received by GlobeMed Gulf.

Responsibilities

• Receive claims from providers
• Audit claims
• Issue “examination of invoice” report to detect and correct flagged discrepancies
• Validate claims
• Organize claims by each provider and then, upon closing, by guarantors and groups
• Issue bordereaux concerning reimbursement and general claims and send them to companies
• Follow up on pending and un-received claims
• Assist in processing different types of claims when needed
• Assist risk-carriers when needed
• Detect & Report cases of Fraud and abuse

Qualifications

• Bachelor’s degree in Nursing, Pharmacy, or related medical field.
• 2–4 years’ experience in medical claims processing within a TPA or insurance company.
• Strong knowledge of ICD-10, CPT codes, and insurance policy terms.
• Skilled in reviewing and validating medical claims, invoices, and supporting documents.
• Familiar with claims adjudication systems (eClaimLink, DHPO, etc.).
• Detail-oriented with good analytical and time management skills.