Health Claims Executive

HAYAH Insurance; Dubai; On-site; AED 167,000 - 279,000; Full time

Job summary

HAYAH Insurance in Dubai/UAE seeks a skilled health claims professional to support health claims management, assessments, and related activities. The role collaborates with partners and reinsurers to resolve inquiries and ensure compliant service delivery.

The ideal candidate has a Bachelor’s degree in a medical field and at least 3 years in health claims. UAE regulations familiarity is essential for effective performance in this role.

Qualifications

• Minimum 3 years of experience in health claims or related field.
• Bachelor's Degree in a medical field.
• Familiarity with UAE health insurance regulations.

Responsibilities

• Handle health claims pre-approvals, assessments, reviews and decisions.
• Coordinate with partners and reinsurance companies.
• Address inquiries, escalations and complaints from regulators, clients, and providers.
• Monitor trends in inquiries and alert management.

Skills

Health claims management

Health claims assessments

Regulatory knowledge

Education

Bachelor's degree in a medical field

Job description

Job purpose

Supports health claims management, handles health claims assessments for Group and Individual Health business and service models, and assists with complaint reviews and client satisfaction.

Area of knowledge

Health claims management. Health claims assessments. UAE health insurance regulations.

Main responsibility

• Handles health claims pre-approvals, assessments, reviews, and provides claims decisions.
• Handles the relationship and communication with partners and reinsurance companies.
• Handles claims inquiries, escalations and complaints shared by regulatory bodies, clients, members, distributors, or any other internal or external party; as well as handles communication with the medical providers to resolve and conclude the said inquiries and escalations in a professional and short response time; maintaining a highly professional and respectful communication style.
• Monitor trends in inquiries and escalations, and alert management to any abnormal or recurring patterns.

Number of years of experience

Minimum 3 years of experience in a field relevant to the skills and experience required for the role.

Education

Bachelor's Degree in a medical field.

Location

Dubai or Abu Dhabi office.