Medical Insurance Specialist

Responsibilities

Preparing and developing plans, policies, procedures, and performance indicators for insurance claims in accordance with the laws and regulations of the Dubai Health Insurance Authority.
Providing advisory support during the development of insurance claims systems and programs to enhance revenue growth and productivity.
Developing medical service pricing policies in coordination with relevant organizational units, in compliance with the applicable laws and regulations in the Emirate of Dubai.
Analyzing growth rates of insurance claims revenues and submitting periodic reports to the direct supervisor.
Studying the reasons for rejected insurance claims and identifying innovative solutions related to medical descriptions and documentation methods, in addition to providing recommendations for system updates accordingly.
Conducting periodic measurement of quality indicators for medical billing processes and motor vehicle accident billing in accordance with the Health Insurance Authority regulations.
Settling medical insurance and motor vehicle accident claims that were rejected by insurance companies and preparing detailed reports in this regard.
Providing technical support to insurance claims officers and medical coding staff during the performance of their duties.
Holding periodic meetings with insurance companies and the Dubai Health Insurance Authority to ensure the settlement of all organizational invoices within the approved timeframes.

Qualifications

Master's or Bachelor's degree in Health Sciences, Insurance Business Administration, or an equivalent field.
Medical Coding Certification.
A Master's degree requires three (3) years of experience in the field of medical insurance.
A Bachelor's degree requires five (5) years of experience in the field of medical insurance.

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