Tamheer - Provider Relation

Reconciliation of the accounts

• Set the targets aligned with the overall forecast
• Review the statements of accounts and ensure it's quality before sending to the providers
• Analyse the statement with documentation including the achievable amounts
• Ensure that the reconciliation is conducted on regular basis and in line with the CCHI regulations

Contract management

• Review the existing and renewed contracts to identify and resolve issues that ensure better commercial terms and improve operation

Better commercial terms

• Monitor the compliance of the providers with the agreements on their claims presentation

Communications and trends resolutions

• Identify the unfavourable trends in medical practice of the providers
• Communicate identified issues that improve the providers management to the claims ,relation team and commercial teams.
• Keep continuous relation with other medical team in the business including the hospitals audit doctors
• Attend to members and providers complaints on medical issues

• logical, analytic, Presentation, assessment and interpretation skills
• communication and negotiation skills.
• Basic to intermediate knowledge of Microsoft Office
• Ability to conduct business in English

Insurance and risk, Laboratory and Pharmacy