Job Description

Job post summary

Date posted:

5 August 2025

Pay:

2,500.00 (AED)-4,000.00 (AED) per month

:

Job Purpose

To support the corporate clients, managing the end-to-end processing and support of health insurance claims, aligned with UAE insurance regulations.

Key Responsibilities & Duties

Claims Handling & Adjudication Support

Review claim submissions to ensure accuracy, completeness, and adherence to policy terms.

Coordinate with TPAs and internal claims units for timely approvals, rejections, and clarifications.

Support pre-authorization requests and follow up with healthcare providers for required documentation.

Claims Dispute & Resolution

Investigate claim rejections and support the appeals process where applicable.

Resolve client and employee concerns regarding delayed or denied claims.

Escalate unresolved disputes to the Claims Supervisor or insurer.

Benefit Verification & Policy Support

Verify coverage eligibility and benefit limits before processing high-value or complex claims.

Educate client HR teams on policy inclusions, exclusions, and claims processes.

Compliance & Audit Support

Ensure compliance with DHA/HAAD regulations and internal claims procedures.

Maintain accurate records of claims for audits.

Assist in preparing compliance reports and responding to audit queries.

Soft Skills

Excellent communication and interpersonal skills.

Strong time management and coordination abilities.

Analytical mindset with attention to detail.

Core Competencies

Teamwork: Collaborate with insurance company, internal departments, TPAs, and clients effectively.

Customer Focus: Deliver prompt and supportive responses to client for their claims needs.

Problem Solving: Proactively address client issues and suggest improvements.

Adaptability: Adjust to evolving client requirements and regulatory updates.

Job Type: Full-time

Pay: AED2,500.00 - AED4,000.00 per month