Revenue Manager

We are seeking a senior, results-driven Insurance Claims & Revenue Cycle Manager with deep expertise in Daman insurance, Abu Dhabi claim workflows, and end-to-end revenue cycle control.

This role carries full accountability for reducing insurance rejections, accelerating collections, and ensuring timely reconciliation of all insurance receivables in compliance with DOH regulations.

Key Responsibilities:

1. Insurance Claims Rejection Reduction:

• Lead and control the entire insurance claims lifecycle (pre-authorization, submission, resubmission, appeal).
• Reduce initial insurance claim rejections to ≤ 3% of total claims within 45 days.
• Actively manage and correct rejection causes related to:
• Physicians (clinical documentation & coding alignment)
• Medical coders (CPT / ICD / DRG accuracy)
• Reception & front desk errors (eligibility, approvals, data capture)
• Implement preventive rejection controls (pre-billing audits, checklist enforcement).

2. Daman-Focused Claims Management:

• Handle Daman Enhanced, Basic, and Thiqa and other insurances workflows with full mastery.
• Maintain up-to-date knowledge of Daman/insurance companies policies, circulars, rules, and exclusions in the Emirate of Abu Dhabi.
• Ensure accurate compliance with clinical pathways, tariff rules, and submission timelines.

3. Insurance Reconciliation & Collections:

• Achieve full reconciliation of all insurance claims within 90 days of submission.
• Track outstanding receivables, mismatches, underpayments, and denials.
• Ensure accurate follow-ups, resubmissions, and justifications until closure.
• Maintain a clean aging report with clear accountability and resolution tracking.

4. Revenue Cycle Control & Reporting:

• Own insurance KPIs including:
• Rejection ratio
• Collection turnaround time
• Claims aging (30 / 60 / 90+)
• Recovery percentage
• Produce Daily, weekly and monthly performance reports for management.
• Identify revenue leakage and implement corrective actions immediately.

5. Cross-Department Leadership:

• Work closely with:
• Doctors (clinical documentation quality)
• Medical coders
• Reception and front office teams
• Finance and operations
• Train and enforce best practices across departments to maintain rejection thresholds.
• Act as the final authority on insurance disputes and escalation matters.

Key Performance Indicators (KPIs):

The following KPIs are tied directly to compensation growth:

• Insurance Reconciliation KPI
• 100% reconciliation of insurance claims within 90 days of submission.
• Claims Rejection KPI
• Reduce and maintain initial rejection rate at or below 3% of total claims within 45 days, including:
• Doctor-related rejections
• Coder-related rejections
• Reception/front desk rejections

Mandatory Qualifications:

• Minimum 10 years of insurance claims experience in Abu Dhabi
• Strong, hands-on experience with Insurance claims
• Deep understanding of:
• DOH regulations
• ICD-10, CPT, DRG coding workflows
• Proven track record of reducing rejection ratios and accelerating collections

This Role Is Not Suitable For:

• Junior or mid-level insurance staff
• Candidates without Abu Dhabi insurance experience

Job Type: Full-time

Pay: AED7,000.00 - AED8,000.00 per month