Insurance Supervisor (Healthplus IVF)

JOB_REQUIREMENTS

Hires in

Not specified

Employment Type

Not specified

Company Location

Not specified

Salary

Not specified

2025-4919

Overview

We are looking for a detail-oriented and results-drivenInsurance Supervisor to join our team at HealthPlus IVF. This role oversees the entire insurance and revenue cycle function from pre-authorization and coding validation to claim submission, reconciliation, and audit readiness. The Insurance Supervisor ensures compliance with DOH, ADHICS, and payer regulations, strengthens relationships with insurers and TPAs, and safeguards financial accuracy across IVF and women’s health services. This position is central to maintaining HealthPlus IVF’s operational integrity and financial sustainability as it transitions into its next phase of growth and digital transformation

Responsibilities

Lead and oversee the end-to-end insurance and claims management cycle, ensuring accuracy, compliance, and timely reimbursement.
Conduct monthly medical and technical audits before claim submission, validating coding integrity and documentation completeness across clinical specialties.
Track and analyze RCM performance KPIs (denial rates, TATs, collection cycles) to ensure alignment with operational and financial targets.
Manage resubmissions of rejected or underpaid claims, analyze root causes, and drive systemic corrective actions.
Oversee referral activity, approval timelines, and claim distribution to coders to maintain efficiency and accountability.
Conduct monthly rejection trend analyses to identify systemic gaps and implement preventive measures in collaboration with clinical and finance teams.
Coordinate bundle cycle billing, package reconciliation, and pre-authorization validation in compliance with DOH and payer guidelines.
Prepare audit-ready documentation for internal reviews, external auditors, Tasneef, and DOH inspections.
Support policy implementation, SOP updates, and ongoing RCM training to reinforce compliance and operational excellence.
Liaise with insurance partners and regulators to resolve escalations and maintain transparent communication channels.

Qualifications

Bachelor’s Degree in Healthcare, Business Administration, or related field.
Minimum 5 years of progressive experience in insurance, revenue cycle, or claims management, preferably within IVF or women’s health.
Certification in medical coding (CPC, CCA, or CCS) is mandatory.
Strong knowledge of UAE payer policies, coding standards, and DOH regulatory frameworks.
Experience managing coders, billing teams, and RCM performance dashboards.
Proficient in Microsoft Office and healthcare systems such as Meditex, OpenJet, and insurance portal platforms.
Familiarity with ADHICS data protection and healthcare compliance standards is an advantage.

Similar jobs