Submission Officer | Al Futtaim Health | Dubai, UAE

Al-Futtaim; Dubai; On-site; AED 134,000 - 201,000; Full time

Job summary

Al-Futtaim is seeking a Claims Analyst to manage timely submissions of IP, OP and Pharmacy claims across multiple insurers in Dubai. The role requires strong medical knowledge, attention to detail and adherence to DHA regulations.

You will collaborate with CDI, coding and preauthorization teams, interact with physicians for clinical justification, and drive process improvements to minimize denials and protect revenue.

Qualifications

• Strong medical background with familiarity in healthcare reimbursement.
• Knowledge of DHA regulations and insurance claim processes.
• Ability to coordinate with physicians, CDI, coding, and approvals teams.
• Excellent communication and negotiation abilities.

Responsibilities

• Ensure timely submissions of IP, OP and Pharmacy claims with medical and technical justification.
• Follow up on QMS with branches and coordinate with physicians on clinical justification.
• Work with insurance approvals and claims re-submission teams to minimize denials.
• Monitor KPIs and educate teams to improve submission efficiency.
• Maintain accurate monthly claims submission data across insurers.
• Coordinate with CDI and other stakeholders to reduce financial risk.

Skills

Medical background

Negotiation skills

Soft skills

Presentation skills

Analytical skills

Job description

About Al-Futtaim

Established in the 1930s, Al-Futtaim is one of the most diversified and progressive privately held regional businesses, headquartered in Dubai. Operating across more than 20 countries, the Group spans automotive, financial services, real estate, retail and health. With more than 40,000 employees, Al-Futtaim represents over 200 of the world’s most recognised brands, including Toyota, Lexus, IKEA, ACE and Marks & Spencer. Driven by its purpose to enrich lives and elevate communities, Al-Futtaim focuses on digital innovation, AI, sustainable growth and strategic partnerships, creating long-term value for customers, communities and partners while building a responsible legacy for future generations.

Job Requisition ID: 182866

About Al-Futtaim

Established in the 1930s, Al-Futtaim is one of the most diversified and progressive privately held regional businesses, headquartered in Dubai. Operating across more than 20 countries, the Group spans automotive, financial services, real estate, retail and health. With more than 40,000 employees, Al-Futtaim represents over 200 of the world’s most recognised brands, including Toyota, Lexus, IKEA, ACE and Marks & Spencer. Driven by its purpose to enrich lives and elevate communities, Al-Futtaim focuses on digital innovation, AI, sustainable growth and strategic partnerships, creating long-term value for customers, communities and partners while building a responsible legacy for future generations.

About the role:

• Timely submissions of claims.
• Improve the quality of claims submission to achieve minimal initial denials
• Work closely with other stakeholders to apply securitizing rules to eliminate the technical denials and reduce the medical denial.
• The role also include stop revenue loss through monitoring and coordination with allconcerned stakeholders like preauthorization and coding team to facilitate timely closure of QMS related to claims coding clarification and codifications.
• Monitor behavioral payment of various payers and corporates to apply timely corrective action to mitigate the financial risk in claims submission

What you will do:

• Ensure timely submissions of all eligible IP,OP and Pharmacy claims with proper medical and technical justification.
• Internal Follow up for raised QMS to concerned branch.
• Interacting with the physicians for the clinical justification of the claims
• Ensure and work closely with the team on complex cases that need experience and specialist knowledge or technical IT support.
• Work closely with Insurance Approvals and Claims re-submission Team to minimize the claims denials
• Making sure that claim submissions are dealt with according to Insurance industry and DHA regulations.
• Comply with submission KPI’s (Key Performance Indicator) , maintain a record of submission KPIs as and when required.
• Educate billing/Approval team to enhance the process flow.
• Ensures that targets are met within turnaround time and while maintaining quality and productivity.
• Coordinate with CDI team to educate the physicians, and other paramedical team to ensure proper claims documentations.
• Maintain accurate monthly data of claims submissions of each insurance company
• Coordination with other business stakeholders to improve overall submission process efficiency.
• Analysis of financial data related to revenue cycle, to identify defaulting payers and work with the concern department on corrective strategies to mitigate the financial risk/s.

Required skills to be successful:

Job-Specific Skills:

• Strong medical background to handle reconciliation efficiently.
• Strong Negotiation skills
• Strong soft skills

Behavioural Competencies:

• Excellent presentation and analytical skills
• Good decision-making