Operations Executive - Corporate Wellness

Pay: 2,500.00 (AED)-4,000.00 (AED) per month

Job Description:

Job Purpose

To support the design, coordination, and execution of wellness initiatives for corporate clients, while also managing the end-to-end processing and support of health insurance claims. This dual-function role ensures seamless service delivery in both wellness and claims, aligned with UAE insurance regulations and client expectations.

Key Responsibilities & DutiesWellness Program Support

· Assist in the design and coordination of wellness programs tailored to client needs.

· Facilitate wellness sessions including health screenings, fitness events, mental health workshops, and awareness campaigns.

· Maintain wellness calendars and manage the execution of scheduled events.

Client & Stakeholder Engagement

· Serve as the primary liaison between client HR teams, wellness service providers, and TPAs.

· Provide regular updates to clients on wellness engagement levels and claims performance.

· Address inquiries and escalate complex matters to relevant internal teams.

Wellness Monitoring & Reporting

· Track wellness program participation rates and compile performance reports.

· Analyze program effectiveness using KPIs and employee feedback.

· Support the preparation of dashboards and reports for client presentations.

Claims Handling & Adjudication Support

· Review claim submissions to ensure accuracy, completeness, and adherence to policy terms.

· Coordinate with TPAs and internal claims units for timely approvals, rejections, and clarifications.

· Support pre-authorization requests and follow up with healthcare providers for required documentation.

Claims Dispute & Resolution

· Investigate claim rejections and support the appeals process where applicable.

· Resolve client and employee concerns regarding delayed or denied claims.

· Escalate unresolved disputes to the Claims Supervisor or insurer.

Benefit Verification & Policy Support

· Verify coverage eligibility and benefit limits before processing high-value or complex claims.

· Educate client HR teams on policy inclusions, exclusions, and claims processes.

Vendor & Provider Coordination

· Schedule and manage services with external wellness vendors and healthcare providers.

· Foster strong working relationships with TPAs and clinics to ensure smooth claims processing and wellness delivery.

· Monitor service levels and turnaround times (TATs), raising concerns as needed.

Communication & Awareness

· Develop and distribute wellness and claims communication materials (e.g., posters, emails, FAQs).

· Promote employee awareness of wellness benefits and claims filing procedures through campaigns.

· Maintain wellness and claims documentation for internal and external communication.

Training & Knowledge Building

· Organize training sessions for employees and HR teams on wellness tools and insurance claim filing.

· Stay updated on industry trends, wellness innovations, and UAE insurance regulations.

· Contribute new ideas to improve employee engagement and claims efficiency.

Compliance & Audit Support

· Ensure compliance with DHA/HAAD regulations and internal claims and wellness procedures.

· Maintain accurate records of claims and wellness activities for audits.

· Assist in preparing compliance reports and responding to audit queries.

Daily DutiesPrimary

· Coordinate logistics for wellness activities and health events.

· Review and follow up on claim submissions and approvals.

· Maintain dashboards and reports for both wellness and claims performance.

· Handle basic client queries related to wellness and claims.

Secondary

· Create wellness content for newsletters and internal platforms.

· Support onboarding of new clients in wellness and claims-related areas.

· Participate in internal team initiatives aligned with HR and employee benefits.

Required Skills & CompetenciesTechnical Skills

· Knowledge of wellness program planning and insurance claims processing.

· Familiarity with UAE healthcare regulations (DHA/HAAD).

· Proficiency in Microsoft Office Suite (Excel, PowerPoint, Outlook).

· Experience with TPA portals or claims platforms (preferred).

Soft Skills

· Excellent communication and interpersonal skills.

· Strong time management and coordination abilities.

· Analytical mindset with attention to detail.

Core Competencies

· Teamwork: Collaborate with internal departments, TPAs, and clients effectively.

· Customer Focus: Deliver prompt and supportive responses to client wellness and claims needs.

· Problem Solving: Proactively address client issues and suggest improvements.

· Adaptability: Adjust to evolving client requirements and regulatory updates.

Educational QualificationsEssential

· Bachelor’s degree in Healthcare, Insurance, Human Resources, or a related field.

Preferred

· Certification in Health & Wellness, Insurance Claims Management, or similar.

· Training in Mental Health Awareness, Wellness Coaching, or Employee Engagement.

· CII, LOMA, or other insurance certifications (advantageous).

Knowledge Requirements

· Familiarity with corporate wellness strategies and mental health initiatives.

· Understanding of UAE health insurance practices, claims procedures, and compliance norms.

· Awareness of wellness ROI measurement and employee engagement techniques.

Job Type: Full-time

Job Type: Full-time

Pay: AED2,500.00 - AED4,000.00 per month