Job Description

Job Summary:

The Insurance Coordinator is responsible for managing all aspects of patient insurance processes, including verification, approvals, billing, claims submission, and reconciliation. This role ensures accurate and timely communication between the clinic, patients, and insurance providers to facilitate smooth claim processing and reimbursement.

Key Responsibilities:

1. Insurance Verification & Eligibility

Verify patient insurance coverage and eligibility prior to consultation or treatment. Confirm patient benefits, exclusions, and approval requirements with insurance companies. Maintain updated records of insurance policies and network agreements.

2. Pre-Authorization & Approvals

Prepare and submit pre-authorization requests for procedures and treatments. Follow up with insurance providers for approval status and documentation. Inform doctors and patients regarding approval outcomes or denials.

3. Claims Processing

Accurately prepare and submit insurance claims (manual and electronic). Ensure all supporting documents, medical reports, and codes are correctly attached. Track claims to ensure timely submission and processing.

4. Payment Posting & Reconciliation

Record received payments and reconcile them with submitted claims. Coordinate with finance to ensure accurate accounting and reporting. Investigate and resolve discrepancies or rejections.

5. Communication & Coordination

Liaise between patients, doctors, and insurance companies regarding claim queries. Provide guidance to patients on coverage limits, co-payments, and exclusions. Maintain confidentiality of patient and financial information at all times.

6. Documentation & Compliance

Maintain comprehensive insurance files and digital records. Ensure compliance with UAE insurance regulations and DHA/DOH guidelines. Update management on policy or network changes impacting clinic operations.

Qualifications & Skills:

Bachelor's degree or equivalent qualification in healthcare administration, finance, or related field. Minimum 2-3 years of experience as an Insurance Coordinator in a healthcare or aesthetic clinic. Strong knowledge of UAE medical insurance systems (e.g., Daman, AXA, NAS, Neuron, MetLife, etc.). Proficiency in medical billing software and Microsoft Office. Excellent communication and negotiation skills. Attention to detail, accuracy, and strong organizational ability. Ability to work under pressure and meet deadlines.

Key Performance Indicators (KPIs):

Claim accuracy rate

- ? 98% error-free submissions.

Turnaround time for pre-approvals

- within 24-48 hours.

Claim rejection/denial rate

- below 5%.

Collection efficiency

- ? 95% of approved claims collected on time.

Compliance adherence

- 100% compliance with DHA/insurance policies.
Job Type: Full-time

Pay: AED4,000.00 - AED4,500.00 per month