Medical Provider Performance Executive

DubaiOn-site5–10 yrsFull-time

Responsibilities

Conduct objective investigations into healthcare provider fraud, waste, and abuse to protect company assets and recover inappropriate payments. Perform data mining and analysis to detect irregularities and collaborate with legal and finance departments to resolve complex cases.

Requirements

Requires a medical background (Doctor, Nurse, or Paramedic) and professional coding certifications such as CPC or CPMA. Candidates must have insurance industry experience, expertise in data analytics tools like Power BI, and strong investigative skills.

Key skills

Fraud InvestigationData MiningData AnalysisMedical CodingClaims ManagementAuditReport WritingInterpersonal SkillsPower BIExcelRegulatory ComplianceCase ManagementStakeholder CommunicationRisk AssessmentMedical AuditingInvestigation Methodology

Apply now

You'll apply on the employer's official page.