Job Description

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.