Key Responsibilities

• Review assigned claim forms and submit pre-approvals to insurance companies with 100% accuracy
• Communicate with departments to obtain missing documents or additional information
• Perform quantitative and qualitative analysis of patient records for compliance and completeness
• Identify documentation deficiencies and ensure corrections are made
• Use historical denial trends to prevent repeat denials and improve first-round approval rates
• Coordinate with coding teams, physicians, and other stakeholders to resolve insurance rejections and minimize revenue loss
• Maintain accurate monthly data of claims submissions and analyze financial data to identify defaulting payors and mitigate financial risks
• Educate billing/approval teams and collaborate with CDI teams to enhance claims documentation and process flow

Skills

Who You Are

• Certified professional coding certificate from a reputed institution (mandatory)
• Certified medical/paramedical certificate preferred
• Minimum 3+ years’ experience in a similar role, with a strong medical background and experience in claims reconciliation
• Fluent in English; Arabic is a plus
• Strong negotiation, analytical, and decision-making skills
• Excellent presentation and communication abilities
• Adaptable and collaborative in a fast-paced clinical environment
• Able to work under pressure and achieve target

Minimum Qualifications & Knowledge

• Bachelor’s Degree or Diploma in a relevant field (medical, paramedical, or coding)
• Certified professional coding certificate (mandatory)
• Advanced IT proficiency
• BLS Certification (preferred)