Healthcare Audit Executive

Location UNITED ARAB EMIRATESSTATE, UNITED ARAB EMIRATES
Experience level Experienced Hire
Job details sector Health

To be responsible for performing providers Audit Campaign, and identifying unfavorable trends in providers billing, maximize audit findings and recovery through providing solid audit ground.  



  • Identify the unfavorable trends in medical practice of the providers
  • Ensure compliance with legal and regulatory claims management, liaising with compliance and legal to ensure the fulfillment of regulatory requirements.
  • Liaise with other FWA Unit to develop Audit campaign on targeted providers improve and develop Audit criteria to expand the current audit activities
  • Support FWA analyst through clinical validation of the analysis
  • Report audit findings in a constructive approach to ensure best outcomes from the performed campaign
  • Identify areas of Gaps caused by current processes, report it for better controlled processed
  • Onsite File review for cases reported by the Medical Board team of possible document manipulation/ fraud



 

  • Proficient Knowledge of the Country’s healthcare Insurance market.
  • Proficient Knowledge of GCC countries healthcare providers trends and behaviors
  • Proficient Knowledge of the various GCC countries legislations and regulations.
  • Sound Medical Knowledge and claims adjudication.
  • Coding certification
  • Preferably Audit certification
  • Paramedic / Medical Degree
  • At least 3 years in a similar position 

 

 

 

 

 

 

At AXA, we support millions of people around the world by protecting them, their families, belongings, assets, businesses and their future.
Present in 64 countries, AXA’s 166,000 employees and exclusive distributors provide their expertise in support of 103 million customers through four core business activities: Property & Casualty Insurance; Life & Savings; Health Insurance; and Asset Management. In a fast-evolving world, AXA anticipates change to offer services and solutions tailored to the current and future needs of its customers.
 
We strive to lead the transformation of our industry. We are looking for talented individuals who come from varied backgrounds, think differently and want to be part of this exciting transformation by challenging the status quo so we can push AXA - a leading global brand and one of the most innovative companies in the world - onto even greater things. At AXA, we want our people to wake up every day with the drive and inspiration of our noble mission; collectively, we want to empower people to live a better life.

With a workforce of over 1,000 employees, 44 branches & retail shops region-wide, more than 1 million customers and 2015 gross written premium of over US$ 963 million, AXA is one of the largest international player in the GCC. Present in the region for more than 65 years, AXA in the Gulf offers a wide range of insurance products and services for corporate, SME and individual customers.
 
Our business is to protect people over the long term. We emphasis on designing reliable solutions to meet the needs of our customers, manage risks in a professional way, treat our partners fairly, develop a work environment built on strong values, relationship and trust
 
We also believe that we have a role to play in protecting the environment, supporting the communities in which we operate, and more broadly in helping to create stronger and more sustainable societies. This is part of creating a sustainable, long-term business, and becoming the preferred company for our customers, employees, and other stakeholders.
 
AXA Gulf has been awarded General Insurance Company of the Year for 2nd consecutive year and Health Insurance Company of the Year at the 2015 Middle East Insurance Industry Awards (MIIA), Insurer of the Year and Personal Lines insurer in 2016 at the MENA Insurance Awards and Best Motor Insurance Product by the Banker Middle East in both UAE & KSA.
 
As part of AXA’s corporate responsibility and its commitment to building better understanding about the health risks faced by individuals and the society, the company achieved a new Guinness world record for the most blood cholesterol readings in 8 hours at a single venue
AXA is the leading insurer in the Gulf and we are looking for individuals who can make a difference. If your aim is to work in an environment that encourages you to grow, develop and enjoy your work, then AXA Gulf is the place for you.