Resubmission and Reconciliation Officer

AlFuttaim; Dubai; On-site; AED 67,000 - 100,000; Full time

Job summary

Al-Futtaim Health in Dubai seeks a Resubmission and Reconciliation Officer to review denied medical claims, resubmit with justified corrections, and reconcile outcomes with insurers. You will drive revenue recovery across IP, OP and Pharmacy claims while reducing denials, coordinating with physicians and payers to meet DHA requirements.

The role emphasizes collaboration with billing teams, approvals staff and insurers to improve documentation and payment timelines.

Qualifications

• Recognised medical coding certificate and a medical/paramedical qualification.
• At least three years in medical claims resubmission, reconciliation or a closely related insurance role.
• Strong negotiation and communication with physicians and payers.

Responsibilities

• Escalate unusual denials and payer issues to the Insurance Manager.
• Resubmit eligible IP, OP and Pharmacy claims within required timelines.
• Attach suitable medical and technical justification to corrected claims.
• Follow up internally on quality-management issues raised to branches.
• Contact payers for clarification regarding rejected submissions.
• Obtain clinical justification from physicians when required.
• Coordinate specialist or technical support for complex cases.
• Ensure resubmissions comply with DHA and insurance regulations.
• Monitor resubmission KPIs and maintain supporting records.
• Analyse the root causes of denials by individual payer.

Skills

Medical claims resubmission

Insurance reconciliation

IP/OP/Pharmacy claims

Medical coding

Denial root-cause analysis

Revenue-cycle mgmt

DHA compliance

Payer negotiation

Clinical justification

Technical denial analysis

KPI reporting

Quality management

Clinical documentation

Payment discrepancy

Financial risk

Education

Medical coding certificate

Medical/Paramedical qualification

Job description

Resubmission and Reconciliation Officer

Resubmission and Reconciliation Officer Job Snapshot * Role: Resubmission and Reconciliation Officer * Location: Dubai, United Arab Emirates * Industry: Hospital and Health Care * Function: Claims Processing * Experience: Minimum 3 years in medical claims resubmission or a similar role

Al-Futtaim Health is hiring a Resubmission and Reconciliation Officer in Dubai, United Arab Emirates, for a revenue-cycle position within the Hospital and Health Care industry. The officer will review rejected medical claims, prepare justified resubmissions and reconcile outcomes with insurance companies. The role supports the recovery of revenue from eligible IP, OP and Pharmacy claims while reducing recurring denials. Close coordination with physicians, billing teams, approvals staff and payers will ensure that submissions meet medical, technical and DHA requirements.

Job Details

Country: United Arab Emirates City: Dubai Industry: Hospital and Health Care Function: Claims Processing Salary: AED 6000-9000 per month Estimated salary range based on similar jobs in Dubai; please confirm the final offer with the employer. Gender: Any Candidate Nationality: Any Job Type: Full-time Job Requisition ID: 180208

Role Context

Rejected claims can delay payment and create avoidable financial exposure for healthcare providers. This position will determine whether denials arise from clinical documentation, coding, technical submission errors or payer-specific rules before taking corrective action. The officer will also analyse patterns across insurance companies and help prevent repeated denials. Accurate reconciliation data and effective communication with clinical teams will strengthen revenue-cycle performance and documentation quality.

Key Responsibilities

• Escalate unusual denials and payer issues to the Insurance Manager.
• Resubmit eligible IP, OP and Pharmacy claims within required timelines.
• Attach suitable medical and technical justification to corrected claims.
• Follow up internally on quality-management issues raised to branches.
• Contact payers for clarification regarding rejected submissions.
• Obtain clinical justification from physicians when required.
• Coordinate specialist or technical support for complex cases.
• Work with Insurance Approvals and Claims Submission teams.
• Ensure resubmissions comply with DHA and insurance regulations.
• Monitor resubmission KPIs and maintain supporting records.
• Analyse the root causes of denials by individual payer.
• Create system rules that help prevent recurring rejection patterns.
• Educate billing and approvals teams on process improvements.
• Meet turnaround, quality and productivity targets.
• Coordinate with the Clinical Documentation Improvement team.
• Help physicians and paramedical staff improve claims documentation.
• Maintain monthly resubmission and reconciliation data by insurer.
• Separate medical denials from technical denials in reports.
• Highlight payer payment discrepancies to line management.
• Analyse revenue-cycle data to identify defaulting payers.
• Recommend corrective strategies that reduce financial risk.

Ideal Profile

Applicants must hold a recognised professional medical-coding certificate and a certified medical or paramedical qualification. At least three years of experience in medical claims resubmission, reconciliation or a closely related insurance role is required. A strong medical background is essential for evaluating clinical denials and communicating effectively with physicians and payers. Candidates should demonstrate confident negotiation, sound decision-making and the ability to analyse complex claim information. The role also requires operational discipline, clear presentation skills and the ability to maintain accuracy while working under pressure and meeting strict turnaround targets.

Skills Set

• Medical claims resubmission
• Insurance reconciliation
• IP, OP and Pharmacy claims
• Medical coding
• Denial root-cause analysis
• Revenue-cycle management
• DHA claims compliance
• Payer communication and negotiation
• Clinical justification review
• Technical denial analysis
• Claims KPI reporting
• Quality Management System follow-up
• Clinical documentation improvement
• Payment discrepancy analysis
• Financial risk identification

Why Join Us

This role provides direct involvement in protecting healthcare revenue and improving claims performance across a growing clinical network. The successful candidate will work with insurers, physicians, coding specialists and operational teams on complex denial and reconciliation matters. Al-Futtaim Health offers long-term stability and opportunities to develop deeper expertise in medical coding, payer relations and revenue-cycle analytics. The multidisciplinary environment also creates scope to influence documentation and claims processes across multiple clinics.

About the Company

Al-Futtaim Group is a diversified, privately held regional business operating across automotive, financial services, real estate, retail and healthcare. The Group employs more than 35,000 people in over 20 countries and partners with more than 200 international brands.