Reconciliation Manager

Job Title: Reconciliation Manager (Healthcare Insurance)

Company: Accumed
Location: United Arab Emirates

Accumed is a leading name in the healthcare sector, and we are looking for a meticulous and results-driven Reconciliation Manager to join our dynamic Insurance Relationship Management team. If you have a deep understanding of healthcare insurance and revenue cycle management, and you excel at minimizing revenue leakage, we want to hear from you.

About the Role:

As a Reconciliation Manager, you will play a critical role in our Denial Management department. You will be responsible for ensuring the accuracy and timeliness of all reconciliation activities between payers and providers. Your primary focus will be on validating claims data, analyzing denial trends, and maximizing claim recoverability to maintain our financial health and operational excellence.

Key Responsibilities:

• Conduct detailed evaluations and retrospective audits of claims to categorize recoverable and non-recoverable amounts.
• Generate and maintain detailed reconciliation reports (summary, claim-wise, activity-wise) on a monthly basis.
• Implement strategies to optimize and maintain the provider claim rejection rate below 5%.
• Solely manage the verification and upload of claims for the reconciliation process.
• Act as the main point for external communication, ensuring the timely and accurate exchange of reconciliation data with payers and providers.
• Analyze denial root causes and lead corrective actions to prevent future revenue leakage.

What We're Looking For (Job Requirements):

• Bachelor’s degree in Management or a related field.
• 7-8 years of experience in the Healthcare or Insurance industry, with a focus on reviewing insurance claims and optimizing rejection rates.
• Proven experience in Healthcare Insurance and Revenue Cycle Management (RCM).
• Strong analytical skills with the ability to work and analyze large databases.
• Excellent proficiency in Microsoft Excel. Knowledge of billing software is a plus.
• Meticulous attention to detail, persistence, and a results-oriented mindset.

Key Performance Indicators (KPIs) You'll Be Measured On:

• Maintain overall claim rejection rate below 5%.
• 100% accuracy in claim evaluation and audit.
• 100% timeliness in claim verification, upload, and report generation.
• Effective external communication and issue resolution.

How to Apply:

If you are an efficient professional with the required experience and are ready to take on this challenging role, we encourage you to apply.

Please note: Only shortlisted candidates who meet the experience criteria will be contacted.

Job Types: Full-time, Permanent

Pay: AED1,000.00 - AED2,000.00 per month