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....