Key Responsibilities
- Review and process assigned claim forms to ensure completeness and accuracy.
- Update approvals received from insurers with 100% accuracy.
- Collaborate with clinical and admin teams to obtain missing documents and clarifications.
- Meet daily claims verification productivity and quality targets.
- Perform quantitative and qualitative analysis of medical records; ensure compliance with coding guidelines, DHA and payer regulations.
- Submit pre‑approvals aligned to KPIs, improving first‑round approval rates.
- Monitor stakeholder coordination to prevent revenue loss and address insurance rejections.
- Analyze denial trends and implement corrective actions; maintain accurate records and escalate denied approvals when needed.
- Educate and partner with billing, approval, and clinical documentation teams to enhance process flow and compliance.
Skills
Qualifications, Experience & Skills
- Emirati national with a valid family book (mandatory)
- Certified professional coding certificate from a recognized institution
- Certified medical/paramedical qualification
- 3+ years of experience in a similar role (RCM, pre‑approvals, insurance submissions)
- Strong medical background for efficient reconciliation
- Excellent negotiation, presentation, and analytical skills
- Operational thinking, sound decision‑making under pressure, and target orientation
- Clear communication and stakeholder management skills in Arabic and English
What You’ll Gain at Al‑Futtaim
- Compensation & benefits: Competitive package aligned with Al‑Futtaim Group standards including comprehensive health insurance, annual leave, performance programs, long‑service recognition,
- BlueRewards discounts, and wellbeing initiatives through HealthHub
- Career growth: Personalised learning (LinkedIn Learning, AI Skills Toolkit) and multi‑directional progression across the Group
- Values‑driven culture: Respect, Integrity, Excellence, Collaboration in action—every day
Location
- Dubai Festival City (RCM hubs and training)