Junior Reviewer – Medical

For MedNet Jordan Co. W.L.L.

MedNet Jordan is one of the leading managed care service organizations that caters to healthcare needs. We are currently seeking to hire Junior Reviewer – Medical (on Hybrid working modules basis) with the following tasks and responsibilities:

Your Job

• Provide authorizations for insured members (In/Out-Patient) and handle calls relating to medical cases efficiently.
• Medical evaluation and daily monitoring of treatment plans for in-hospital cases in respect of medical necessity and appropriateness.
• Evaluation & approval of outpatient claims need authorization in respect to the medical necessity and appropriateness and check them in the system to ensure high quality and correct services.
• Performs medical case management using established criteria and clinical guidelines.
• Manage queries from providers, Insurance Companies and insured members relating to authorization, evaluation and administration.
• Responding to all international accounts requests and all inquiries from insurance companies.
• Deliver excellent customer services to Insurance Companies and insured members with view of achieving maximum client satisfaction.
• Medical Updating of the Medical File related to insured members regarding their investigations results like MRI, CT scan, etc….

Qualifications

Your Profile

• Bachelor Degree in Medicine and Surgery or Dentistry.
• Computer literacy (MS Office, Excel, PowerPoint)
• Knowledge related to medical terminologies.
• Industry knowledge related to local healthcare services system would be a plus.
• Good Command in English language.