Medical Claims Executive - Emiratization

AlFuttaim; Dubai; Presencial; AED 60 000 - 90 000; Tempo integral

Resumo da oferta

Orient Insurance PJSC, part of the Al-Futtaim Group, seeks a Medical Claims Executive under Emiratization in Dubai. The role involves reviewing and processing medical insurance claims, verifying policy coverage, and coordinating with hospitals and providers to ensure accurate documentation and timely processing.

The position targets Emirati graduates with healthcare qualifications, offering exposure to claims workflows and regulatory compliance within a leading insurer in the UAE.

Qualificações

• A bachelor’s degree in medicine, pharmacy, medical laboratory sciences, nursing, biomedical sciences or related healthcare discipline is required.
• Fresh graduates are encouraged to apply; healthcare internships are an advantage.

Responsabilidades

• Review and process medical insurance claims accurately and within service standards.
• Assess claims against policy coverage, benefits and exclusions.
• Verify information and ensure documentation is complete before processing.

Conhecimentos

Medical knowledge

Analytical skills

Communication

Organization

Customer service

Formação académica

MBBS

Pharmacy

Medical Laboratory Sciences

Nursing

Biomedical Sciences

Other healthcare discipline

Ferramentas

Microsoft Office

Claims processing software

Electronic records systems

Descrição da oferta de emprego

Medical Claims Executive - Emiratization Job Snapshot - Role: Medical Claims Executive - Emiratization - Location: Dubai, United Arab Emirates - Industry: Insurance - Function: Claims Processing - Experience: Fresh graduates welcome; healthcare-related experience or internships are an advantage but not mandatory - Job Type: Full Time - Work Arrangement: On-site

Position Overview Orient Insurance PJSC, part of the Al-Futtaim Group, is seeking a motivated and detail-oriented Medical Claims Executive to join its Medical Claims team in Dubai, United Arab Emirates. This position is offered under the company 's Emiratization initiative and is open to Emirati nationals holding a UAE Family Book. It is particularly suitable for fresh graduates with qualifications in medicine, pharmacy, nursing, medical laboratory sciences, biomedical sciences or related healthcare disciplines. The Medical Claims Executive will review, assess and process medical insurance claims, ensuring that submitted documentation is accurate, policy coverage is verified and claims are handled according to company procedures, medical guidelines and applicable regulatory requirements. The role involves coordinating with hospitals, clinics, healthcare providers and internal stakeholders to obtain necessary information, resolve documentation issues and support timely claims processing. The successful candidate will bring an understanding of medical terminology, strong analytical abilities and a customer-focused approach to claims administration.

Job Details – Country: United Arab Emirates – City: Dubai – Industry: Insurance – Function: Claims Processing – Salary: Not disclosed – Gender: No Preference – Candidate Nationality: Emirati – UAE Family Book Required – Job Type: Full Time – Work Arrangement: On-site

Key Responsibilities

Medical Insurance Claims Assessment

• Review and process medical insurance claims accurately and within agreed service standards.
• Assess submitted claims against applicable policy coverage, benefits and exclusions.
• Examine medical reports, treatment records and supporting documentation to evaluate claim eligibility.
• Apply company procedures and medical guidelines when reviewing claims.
• Verify that relevant information is complete and consistent before progressing claims through the assessment process.
• Identify discrepancies or incomplete information that may affect claim processing.
• Escalate complex claims and cases requiring further review through the appropriate internal channels.

Medical Documentation Verification

• Review medical claim forms and accompanying healthcare documentation for accuracy and completeness.
• Verify relevant treatment records, medical reports and supporting information.
• Identify missing documents and coordinate requests for additional information.
• Maintain attention to detail when examining medical terminology and treatment-related information.
• Support accurate claims assessment by ensuring the necessary documentation is available.
• Follow established procedures when handling and recording claim information.

Healthcare Provider and Stakeholder Coordination

• Communicate with hospitals, clinics and other healthcare providers regarding medical claims documentation.
• Coordinate with internal stakeholders to obtain additional information required for claims assessment.
• Follow up on outstanding documentation and clarification requests.
• Maintain professional working relationships with healthcare providers and relevant internal teams.
• Support efficient communication throughout the claims review and processing cycle.
• Help resolve administrative issues that may delay claim assessment.

Claims Administration and Record Management

• Maintain accurate medical claims records within the claims management system.
• Update claim information and processing status as required.
• Ensure supporting documentation is properly recorded and maintained.
• Follow established administrative procedures to support consistency and accuracy.
• Monitor assigned claims activities to help meet agreed service timelines.
• Maintain organized records that support effective claims handling and internal review.

Customer and Healthcare Provider Support

• Respond professionally to customer and healthcare provider inquiries regarding claim status.
• Explain documentation requirements clearly to relevant stakeholders.
• Provide accurate information about claims processing requirements within the scope of the role.
• Support timely communication when additional documentation or clarification is required.
• Maintain a service-oriented approach when handling inquiries and administrative concerns.
• Contribute to a positive customer and provider experience through clear communication and responsive support.

Compliance and Quality Assurance

• Ensure medical claims activities comply with company policies, medical protocols and applicable regulatory requirements.
• Follow established procedures for claims verification, assessment and processing.
• Maintain accuracy and consistency when reviewing medical insurance information.
• Identify irregularities and escalate matters requiring additional assessment.
• Support adherence to internal quality standards and claims processing guidelines.
• Demonstrate professionalism and accountability when handling claims documentation.

Process Improvement and Operational Efficiency

• Participate in initiatives aimed at improving medical claims processing efficiency.
• Identify recurring documentation issues and administrative challenges.
• Share observations that may help improve claims workflows.
• Support measures designed to reduce processing delays and improve service quality.
• Contribute to continuous improvement activities that enhance customer experience and operational performance.

Required Qualifications

Emiratization Eligibility

• Applicants must be Emirati nationals holding a UAE Family Book.
• UAE nationality and Family Book eligibility are mandatory requirements for this position.

Educational Qualifications

• A bachelor 's degree in one of the following medical or healthcare-related disciplines is required:
• Medicine (MBBS)
• Pharmacy
• Medical Laboratory Sciences
• Nursing
• Biomedical Sciences
• Another medical or healthcare-related discipline

Professional Experience

• Fresh graduates are encouraged to apply.
• Previous internship experience is an advantage but is not mandatory.
• Healthcare-related professional experience is beneficial but not required.
• Candidates must demonstrate a strong interest in developing a career within the insurance industry.

Required Skills and Competencies

Medical Knowledge and Analytical Skills

• Good understanding of medical terminology and healthcare concepts.
• Strong analytical and problem-solving abilities.
• Ability to review medical information and supporting documents carefully.
• Attention to detail and accuracy when assessing claims documentation.
• Capacity to identify inconsistencies and recognize cases requiring further review.
• Willingness to learn medical insurance claims procedures and coverage assessment practices.

Communication and Customer Service

• Excellent verbal and written communication skills.
• Professional communication when dealing with healthcare providers, customers and internal stakeholders.
• Customer-focused and service-oriented approach.
• Ability to communicate documentation requirements clearly.
• Strong interpersonal skills and a collaborative working style.
• Commitment to providing responsive and professional support.

Organization and Workload Management

• Strong organizational and time management skills.
• Ability to work under pressure and manage high volumes of work effectively.
• Capacity to handle multiple claims and administrative priorities.
• Ability to meet service deadlines while maintaining accuracy.
• Attention to proper documentation and record management.
• Ability to work independently and contribute effectively within a team.

Technical Skills

• Proficiency in Microsoft Office applications.
• Ability to maintain accurate information within administrative and claims management systems.
• Confidence working with electronic records and supporting documentation.
• Willingness to develop familiarity with insurance claims processing tools and procedures.

Career Opportunity

This position provides an opportunity for Emirati graduates from medical and healthcare-related disciplines to apply their academic knowledge within the insurance sector. The role offers practical exposure to medical claims assessment, policy coverage verification, healthcare documentation and coordination with medical service providers. Candidates will have the opportunity to develop their understanding of medical insurance operations while strengthening analytical, administrative and customer service skills. The position is suited to individuals who enjoy working with medical information, have strong attention to detail and are motivated to build a long-term professional career in insurance.

About Orient Insurance PJSC

Orient Insurance Company commenced operations in 1982 as part of the Al-Futtaim Group and has established a significant presence in the United Arab Emirates insurance market. The company has a paid-up capital of AED 500 million and maintains its head office in Dubai. Orient Insurance serves customers through a branch network covering Jebel Ali, Abu Dhabi, Al Ain, Sharjah and Ras Al Khaimah in the UAE, alongside operations in Muscat, Oman; Riyadh, Saudi Arabia; and Bahrain. As part of the Al-Futtaim Group, Orient Insurance operates within a diversified regional business established in the 1930s and headquartered in Dubai. Al-Futtaim operates across more than 20 countries, employing over 40,000 people in automotive, financial services, real estate, retail and health businesses. The Group represents more than 200 internationally recognized brands, including Toyota, Lexus, IKEA, ACE and Marks & Spencer. With a focus on digital innovation, sustainable growth and customer service, Al-Futtaim continues to develop its businesses while supporting customers and communities across the region.