Revenue Cycle Manager - Claims Resubmission

AlFuttaim; Dubai; On-site; AED 167,000 - 246,000; Full time

Job summary

Al-Futtaim Health in Dubai is seeking a Revenue Cycle Manager - Claims Resubmission to optimize healthcare revenue by overseeing resubmission of inpatient, outpatient, and pharmacy claims, ensuring proper medical justification and timely submissions across payer timelines.

The ideal candidate has at least four years of experience in claims resubmission or denial management, a professional coding certification, and a strong medical background to interpret documentation and negotiate

Qualifications

• Minimum 4 years of experience in healthcare claims resubmission or denial management.
• Professional coding certification required.
• Strong medical background to interpret clinical documentation and negotiate with payers.

Responsibilities

• Manage timely resubmission of eligible inpatient, outpatient, and pharmacy claims.
• Review rejected claims to identify medical, technical, documentation, authorization, coding, or payer issues.
• Obtain appropriate clinical justification from physicians for rejected claims requiring additional medical evidence.
• Strengthen resubmission quality to improve recovery rates and reduce denials.
• Coordinate with Insurance Approvals and Claims Submission teams to identify preventable causes of rejected claims.
• Ensure resubmissions comply with DHA regulations and industry procedures.
• Track KPIs, turnaround times, productivity, and recovery performance across the team.
• Provide coaching to strengthen denial-management capabilities.

Skills

Revenue cycle management

Claims resubmission

Insurance denial management

Medical coding

Payer reconciliation

DHA regulations

Clinical documentation improvement

Team supervision

Education

Professional coding certification

Certified medical/paramedical qualification

Job description

Job Snapshot

Revenue Cycle Manager - Claims Resubmission Job Snapshot Role: Revenue Cycle Manager - Claims Resubmission Location: Dubai, United Arab Emirates Industry: Hospital and Health Care Function: Hospital-Clinic Administration Experience: Minimum 4 years Job Type: Full-time

Job Details

Country: United Arab Emirates
City: Dubai
Industry: Hospital and Health Care
Function: Hospital-Clinic Administration
Salary: 15000-22000 Estimated salary range based on similar jobs in the job city; please confirm the final offer with the employer.
Gender: Any
Candidate Nationality: Any
Job Type: Full-time

Role Context

The Revenue Cycle Manager - Claims Resubmission is responsible for recovering eligible healthcare revenue while addressing the underlying causes of rejected and underpaid insurance claims. The position oversees resubmission and reconciliation activities covering inpatient, outpatient, and pharmacy claims, ensuring cases are supported by appropriate medical and technical justification. A major part of the role involves examining payer behaviour, denial patterns, documentation gaps, approval issues, and payment discrepancies. By coordinating with physicians, Clinical Documentation Improvement teams, insurance approvals, claims submission teams, insurance companies, and TPAs, the manager will help reduce recurring denials and improve the predictability of healthcare revenue.

Key Responsibilities

• Manage timely resubmission of eligible inpatient, outpatient, and pharmacy insurance claims within applicable regulatory and payer deadlines.
• Review rejected claims and determine whether denials originate from medical, technical, documentation, authorization, coding, or payer-related issues.
• Obtain appropriate clinical justification from physicians for rejected claims requiring additional medical evidence.
• Strengthen resubmission quality to improve recovery rates and reduce repeat insurance denials.
• Coordinate with Insurance Approvals and Claims Submission teams to identify preventable causes of rejected claims.
• Ensure claim resubmissions comply with DHA requirements, insurance regulations, contractual conditions, and applicable industry procedures.
• Track resubmission KPIs, turnaround times, productivity, quality, and recovery performance across the team.
• Guide team members through complex denial cases requiring specialist medical knowledge, coding expertise, or technical IT assistance.
• Perform root-cause analysis of payer denials and translate recurring findings into preventive controls.
• Develop system rules and process improvements designed to prevent known denial scenarios from recurring.
• Educate billing and approval teams on issues affecting claim acceptance and recommend improvements to workflow.
• Coordinate with Clinical Documentation Improvement teams to strengthen physician and paramedical documentation supporting insurance claims.
• Maintain detailed monthly records of claims resubmission and reconciliation activity for individual insurance companies.
• Support timely quarterly, semi-annual, and annual reconciliation closure and payer signoff processes.
• Analyze payer payment behaviour and identify delayed, inconsistent, or potentially defaulting accounts.
• Escalate material payment discrepancies and revenue risks to departmental leadership with supporting analysis.
• Maintain structured denial data separating technical denials from medical denials to support targeted corrective action.
• Examine revenue cycle financial data to identify trends that may create collection or cash-flow exposure.
• Work with relevant departments to establish corrective strategies for payers presenting elevated financial risk.
• Build productive working relationships with insurance companies and TPAs to support reconciliation and claim resolution.
• Monitor daily team targets while maintaining appropriate standards for accuracy, productivity, and turnaround time.
• Provide continuous coaching and training to strengthen resubmission, reconciliation, coding, and denial-management capabilities.
• Facilitate closure of quality management matters connected with resubmission and reconciliation activities.

Ideal Profile

Candidates should have at least four years of relevant experience in healthcare claims resubmission, denial management, reconciliation, or a comparable revenue cycle position, including experience taking responsibility for resubmission activities. A recognized professional coding certification is required, together with a certified medical or paramedical qualification. A strong medical background is important because the position regularly involves interpreting clinical justification, reviewing rejected claims, and negotiating reconciliation matters with payers. Practical understanding of healthcare insurance processes, payer requirements, medical and technical denials, claim documentation, reimbursement controls, and DHA regulations will be essential. The role also requires confident negotiation with insurance companies, strong analytical judgment, and the ability to interpret financial and operational data. Leadership experience, conflict management, critical thinking, presentation ability, and supervisory skills are important for directing team performance and resolving complex cases.

Skills Set

• Healthcare revenue cycle management
• Claims resubmission
• Insurance denial management
• Claims reconciliation
• Medical coding
• Professional coding certification
• Medical denial analysis
• Technical denial analysis
• Root-cause analysis
• Inpatient claims
• Outpatient claims
• Pharmacy claims
• Insurance approvals
• Claims submission
• Payer reconciliation
• TPA coordination
• DHA regulations
• Clinical justification review
• Clinical Documentation Improvement
• Healthcare billing
• Revenue recovery
• Revenue leakage prevention
• Payer performance analysis
• Payment discrepancy analysis
• Financial risk analysis
• Resubmission KPI management
• Turnaround time monitoring
• Claims documentation
• Insurance negotiation
• Revenue cycle reporting
• Team supervision
• Process improvement

Why Join Us

Healthcare revenue cycle performance has a direct impact on the financial sustainability of clinical services, making effective denial prevention and claim recovery increasingly important within the Hospital and Health Care sector. This position offers the opportunity to influence revenue protection at both operational and process levels rather than focusing solely on individual claim transactions. Within Al-Futtaim Health, the role provides exposure to multidisciplinary clinical operations, insurance companies, TPAs, medical coding, documentation improvement, and financial analysis. It offers a strong progression path for an experienced claims professional seeking broader responsibility in healthcare revenue cycle leadership and payer management.

About the Company

Al-Futtaim is a diversified regional group headquartered in Dubai with operations spanning healthcare, automotive, retail, real estate, and financial services. Through Al-Futtaim Health and its HealthHub network, the group delivers multidisciplinary healthcare services across Dubai, supported by integrated clinical, administrative, insurance, and revenue cycle operations.