Lead Medical Claims Submissions & Revenue Cycle

Al Futtaim Private Company (LLC); Dubai; In loco; AED 50.000 - 90.000; Tempo pieno

Descrizione del lavoro

Al Futtaim Private Company (LLC) in Dubai is seeking a Billing & Claims Specialist to manage submission of IP, OP and Pharmacy claims with medical and technical justification. You will collaborate with physicians and insurers to ensure DHA-compliant submissions, reduce denials, and guide the billing team to optimize the revenue cycle.

Minimum 3 years in a similar role with certified coding and medical certificates is required.

Competenze

• Certified professional coding certificate from a reputed institution.
• Certified medical/paramedical certificate.
• Minimum 3+ years’ experience in a similar role.

Mansioni

• Submit IP, OP and Pharmacy claims with medical and technical justification.
• Follow up with branch on QMS issues.
• Interact with physicians for clinical justification of claims.
• Assist with IT support for complex cases requiring specialist knowledge.
• Coordinate with Insurance Approvals and Claims re-submission to minimize denials.
• Ensure submissions comply with DHA regulations and industry standards.
• Educate billing/Approval team to enhance process flow.
• Maintain accurate monthly data of claims submissions per insurer.
• Analyze revenue cycle data to identify defaulting payers and inform corrective actions.

Conoscenze

Medical background

Negotiation skills

Soft skills

Formazione

Certified professional coding

Certified medical/paramedical certificate

Descrizione del lavoro

Al Futtaim Private Company (LLC) in Dubai is seeking a Billing & Claims Specialist to manage submission of IP, OP and Pharmacy claims with medical and technical justification. You will collaborate with physicians and insurers to ensure DHA-compliant submissions, reduce denials, and guide the billing team to optimize the revenue cycle.

Minimum 3 years in a similar role with certified coding and medical certificates is required.