Transguard Careers – Customer Service Advisor

Website Transguard Group

Job Description:

Transguard Group was established in 2001 and has diversified significantly, we lead in the fields of Cash Services, Security Services, Manpower Services, Facilities Management & Aviation. Transguard Group is the UAE’s most trusted business support and outsourcing provider and has a large, dynamic, and culturally diverse workforce with 50,000 employees! We are currently recruiting for a Customer Service Advisor-Healthcare for our Client which is based in Dubai.

Job Responsibilities:

  • Sort & register all received claims and ensure claims are properly documented.
  • Issue all the Medical ID Cards for all the Beneficiaries
  • Check all payments including cheque/draft values and other supporting enclosures for technical and clerical accuracy
  • Enter all data in CIRIS for policy and endorsements issuance
  • Ensure that all Enrollment/Application documentation is filed and stored in the dedicated manual and/or electronic retrieval system
  • Receive claims from the reception or via eclaims download
  • Supervise In-patient claims (this supervision includes visits to the patients during their hospitalization)
  • Ensure that all claims documentation is filed and stored in the dedicated manual and/or electronic retrieval system
  • Analyze prior-approval requests, negotiate the cases with the medical providers, approve the cases when agreement is reached and enter the claim into Ciris.
  • Communicate with Insured Members on their claims and on any request coming from an Insured Member
  • Review all the enrollment/application forms to ensure they are complete

Job Requirements:

  • To possess and demonstrate knowledge of Medical Policy wordings for policies issued.
  • Computer Skills, Word, Excel and Data entry
  • English speaking and writing
  • The job requires a sound knowledge of all medical insurance policies and billing policies.
  • The job requires expert knowledge of medical conditions, treatments and procedures in order to guide claimants and challenge medical practitioners and healthcare providers.
  • 2 years in clinical/paramedical field and preferably customer contact experience
  • Clinical or paramedical qualifications/ degree required at Tertiary level

Job Details:

Company: Transguard Group

Vacancy Type:  Full Time

Job Location: Dubai, United Arab Emirates

Application Deadline: N/A

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