Medical Insurance Coding Auditor

Aspris; Dubai; On-site; AED 80,000 - 120,000; Full time

Job summary

A leading healthcare company is seeking a Junior Insurance Coordinator to manage and analyze financial reports related to insurance claims, ensure compliance with regulations, and coordinate with insurance companies. The ideal candidate will have a Bachelor's degree, coding certification, and at least 10 years of relevant experience. Strong analytical skills and proficiency in billing software are required to excel in this role.

Qualifications

• 10 years of experience in Insurance Coordination or Revenue Cycle Management required.
• Strong understanding of insurance processes and claim management.
• Proficiency in English, both written and spoken.

Responsibilities

• Analyze financial reports related to insurance claims and payments.
• Ensure compliance with laws and regulations on insurance billing.
• Coordinate pre-authorization services per medical coding guidelines.

Skills

Communication

Negociation

Analytique

Résolution de problèmes

Education

Bachelor’s degree in Finance

Coding certification

Tools

Medical billing software

Job description

Job description

· Generate and analyze financial reports related to insurance claims, payments, and denials.

· Provide regular updates and insights to management on revenue cycle performance and areas for improvement.

· Ensure compliance with all relevant laws, regulations, and accreditation standards related to insurance billing and revenue cycle management.

· Identify and mitigate risks associated with insurance claims and payments.

· Obtaining prior approvals for the services requiring pre-authorization as per medical coding guidelines.

· Coordinating with any requirements from Insurance companies and following insurance protocols

· Checking all the coverage and member eligibility

· Informing front desk staff for any new protocols received from insurance companies

· Ensuring approvals are received with correct details

· Ensure that the invoices are correctly done in line with what is approved

· Working with problem claims & denials

· Co-ordination OP cases regarding various CPT codes used for accurate and effective Billing

· Ensuring Pre-approval process is done as per the DOH and DHA coding guidelines

· To liaise with patients regarding their eligibility, entitlements, and coverage of medical benefits

· Assist on submitting the claims on timely manner.

The Junior Insurance Coordinator must be clear and concise in communication to Insurance companies, doctors, and patients.

· Adheres to dress code, appearance to maintain neat and clean

· Always maintains and ensure patient confidentially

· Reports to work on time and as scheduled

· Work at maintaining a good rapport and cooperative working relationship with Insurance companies, doctors, and patients.

Knowledge / Education / Skills:

1. Bachelor’s degree in Finance, Business Administration, Healthcare Management, or a related field.

2. Must have a coding certification

2. Minimum of 10 years of experience in Insurance Coordinator, Revenue Cycle Management, Medical Billing, or a related role.

3. Strong understanding of insurance processes, claim management, and medical audits.

4. Proficiency in relevant software and systems for medical billing and revenue cycle management.

5. Excellent communication, negotiation, and interpersonal skills.

6. Strong analytical and problem-solving abilities.

Proficiency in English language, both written and spoken.

Experience:

10 years (Required)