Job Description

Responsibilities

• Ensure high accuracy in claims processes for insurance and corporate review, adhering to contractual agreements for efficient reimbursement.
• Coordinate with insurance companies for eligibility verification, payment approvals, and reconciliation.
• Provide customer service support for insurance verification, eligibility, and preauthorization.
• Accurately liaise with staff to ensure timely entry of insurance information and benefits.
• Verify claims compliance with billing guidelines.
• Coordinate with doctors and senior officers to provide updates and training on insurance and billing guidelines.
• Communicate insurance guidelines and procedures to front-line staff.
• Support other departments and payers in tracking payments.
• Monitor receivables and conduct financial reconciliation for remittance advice.
• Maintain proper records and files for claims correspondence with insurance and private or corporate businesses.
• Participate in training and developing new staff, providing guidance as needed.
• Assist supervisors and managers with internal and external audits.
• Contribute to developing insurance guidelines, frameworks, and processes within MH.
• Analyze claim adjustments, bad debt provisions, and contractual allowances.
• Perform accuracy checks for all claim submissions and resubmissions as per agreed contracts.
• Coordinate discussions between billing clerks and utilization nurses for insurance claims process.
• Manage a collection desk for outstanding balances in the revenue cycle process.
• Develop claim reports for analysis and performance measurement.
  

Qualifications

• Bachelor’s Degree in Finance, Accounting, Business Administration or related fields
• 4-5 years of career experience
• Experience within Finance/ Accounting/Insurance environment in a healthcare facility
• Familiar with UAE Insurance practices