Overview

The Officer, Insurance Service, reports to the Supervisor, Insurance Services, and is accountable for providing vital support to the finance and insurance teams in their daily insurance activities. This multifaceted role involves various responsibilities, including but not limited to handling authorizations, submissions, resubmissions, and processing medical claims. The Officer ensures that all insurance-related tasks are carried out in strict accordance with MH\'s relevant insurance procedures and guidelines. Their dedication and attention to detail contribute significantly to the smooth functioning of insurance operations, ultimately facilitating efficient patient care.

Responsibilities

• Ensure high accuracy in claims processes for insurance and corporate review, adhering to contractual agreements for efficient reimbursement.
• Provide customer service support for insurance verification, eligibility, and preauthorization.
• Accurately liaise with staff to ensure timely entry of insurance information and benefits.
• Verify claims compliance with billing guidelines.
• Communicate insurance guidelines and procedures to front-line staff.
• Support other departments and payers in tracking payments.
• Maintain proper records and files for claims correspondence with insurance and private or corporate businesses.
• Contribute to developing insurance guidelines, frameworks, and processes within MH.
• Analyze claim adjustments, bad debt provisions, and contractual allowances.
• Perform accuracy checks for all claim submissions and resubmissions as per agreed contracts.
• Coordinate discussions between billing clerks and utilization nurses for insurance claims process.
• Manage a collection desk for outstanding balances in the revenue cyc

Qualifications

Required:

• Bachelor\xe2\x80\x99s Degree in Finance, Accounting,Business Administration or related fields.
• Two to three (2-3) years of progressive career experience in Finance/Accounting/Insurance environment in a healthcare facility.
• Strong analytical and problem-solving skills.
• Knowledge of revenue cycle management within the healthcare environment.
• Knowledge of basic medical coding and third-party operating procedures and practices.
• Knowledge of medical billing/collection practices.
• Proficiency with Microsoft Office suite.
• Fluency in written and spoken English.

Desired:

• Certification in Coding.

• Experience in insurance practices in the UAE.

• Fluency in written and spoken Arabic.

Mubadala Health