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claims analyst

MH Enterprises

Key Responsibilities1. Claim Intake, Validation &amp; Documentation<ul><li>Receive and log all types of claims including:</li><li>Validate claim eligibility against supplier agreements, commercial terms, and approved promotions.</li><li>Ensure claims are supported by proper documentation &mdash; debit notes, invoices, promotional agreements, sell-out reports, credit notes, proof of activity, etc.</li><li>Verify calculations, pack sizes, and quantities to ensure accuracy before submission to suppliers.</li></ul>2. Stakeholder Coordination &amp; Approvals<ul><li>Coordinate with Brand Managers / Trade Marketing to validate promotions and scheme eligibility.</li><li>Liaise with Finance &amp; Accounts for claim entries, JV postings, and accounting provisions.</li><li>Ensure all internal approvals are obtained prior to sending claims to suppliers.</li></ul>3. Reconciliation, Tracking &amp; Settlement<ul><li>Maintain a comprehensive claim tracker detailing open, approved, rejected, and settled claims &mdash; with values, dates, claim types, and supporting references.</li><li>Reconcile claim balances with supplier statements and internal ledgers.</li><li>Regularly follow up with suppliers for claim settlement (through VCINs / credit notes / cheque settlements / net-offs).</li><li>Highlight delays, aged claims, or disputed amounts to Brand / Finance leadership for escalation.</li><li>Assist in month-end closing by ensuring correct accounting of provisions for unsettled claims.</li></ul>4. Reporting &amp; Escalation<ul><li>Prepare and share weekly/monthly claim status reports with Brand Managers, Finance, and Management.</li><li>Provide visibility on claim ageing, pending approvals, rejected claims, and settlement timelines.</li><li>Escalate critical issues such as high outstanding amounts, repeated rejections, or delays beyond agreed timelines.</li></ul>5. Compliance &amp; Process Improvement<ul><li>Ensure all claims adhere to company policies, SOPs, and audit requirements.</li><li>Maintain a proper audit trail of all supporting documents, approvals, and supplier communications.</li><li>Identify process gaps and propose improvements to reduce claim processing time and financial leakage.</li><li>Support automation initiatives like ERP claim modules, digital approvals, or dashboards.</li></ul>Skills &amp; Competencies<ul><li>Strong Excel skills for claim calculations, tracking &amp; reconciliations.</li><li>Familiarity with ERP systems</li><li>Good understanding of FMCG trade terms, promotions, and supplier agreements is preferred.</li><li>High attention to detail and accuracy.</li><li>Strong coordination and follow-up skills with internal &amp; external stakeholders.</li><li>Commercial acumen and basic accounting knowledge.</li></ul>Job Type: Full-timePay: AED4,000.00 - AED5,000.00 per month

Accounts Executive - Claims

Allianz

Key responsibilities/What you do: <ul> <li>Review and assess medical claims for both inpatient and outpatient services to determine coverage eligibility and compliance with policy terms.</li> <li>Validate Diagnosis-Related Group (DRG) coding for inpatient admissions using ICD-10-CM and CPT standards, ensuring alignment with clinical documentation.</li> <li>Apply thorough knowledge of UAE healthcare billing regulations, including DHA, DOH, and MOH guidelines, to ensure claims meet local compliance standards.</li> <li>Identify and rectify incomplete or inaccurate claim submissions.</li> <li>Ensure all required documentation is present and properly coded aligning with policy guidelines.</li> <li>Notify payers regarding claims that exceed predefined financial thresholds, ensuring timely communication and resolution.</li> <li>Track and maintain both quantitative (volume) and qualitative (accuracy) metrics for claims processing.</li> <li>Achieve assigned daily processing targets while maintaining high levels of accuracy and efficiency.</li> <li>Collaborate with internal departments to resolve claim-related queries.</li> <li>Perform other responsibilities as assigned by the department lead, in line with the scope of the role.</li> </ul>

Medical Claims Senior Assessor

Allianz Partners

Senior claims Assessor provides quality service to clients, promptly and effectively assesses and process claims and approval according to operations set standards.Senior claims Assessor is also responsible for team success by agreeing, implementing and monitoring individual and team objectives and targets ensuring company policies and procedures are adhered to.What You DoEvaluates medical claims from the technical and medical perspectives as per policy terms and conditions.Channels claims Assessors in handling difficult medical cases and optimize the quality and quantity output.Checks particular treatment plan is necessary for the patient.Refers for a second opinion for cases where there is doubt in treatment plan.Provides clients an understanding of any declined medical claims.Maintains daily productivity targets and service levels.Manages routine daily claims administration work.Coordinates work flow &amp; meet deadlines.Provides on job training/support to team members as necessary.What You BringBachelor s of Nursing or any other paramedical domain.2+ years Medical Practical Experience (reputable insurance provider, broker or a TPA experience a plus).Physically fit to carry out duties.Legally permitted to work in the country of operations.Fluency in MS Office (Excel, Word, Outlook, PowerPoint) and general internet navigation and research skillsWhat We OfferOur employees play an integral part in our success as a business. We appreciate that each of our employees are unique and have unique needs, ambitions and we enjoy being a part of their journey.We are there to empower and encourage you with your personal and professional development ensuring that you take control by offering a large variety of courses and targeted development programs. All that in a global environment where international mobility and career progression are encouraged. Caring for your health and wellbeing is key priority for us.

Reimbursement Senior Assessor

Alliance Insurance Abu Dhabi

Responsibilities: Receive, review, and process medical insurance claims submitted by policyholders or healthcare providers.
Adjudicate claims based on policy terms, coverage limits, and medical necessity criteria.
Verify the accuracy and completeness of claim forms, medical records, and supporting documentation.
Investigate questionable claims by contacting healthcare providers, requesting additional information or documentation, and analysing medical records.
Make decisions on claim approvals, denials, or requests for additional information based on investigation findings and policy guidelines.
Ensure timely and accurate processing of approved claims for payment, including coordinating with finance departments and third-party administrators.
Communicate with policyholders, healthcare providers, and internal stakeholders regarding claim status, decisions, and any required actions.
Maintain detailed records of claims, correspondence, and investigation outcomes in accordance with regulatory requirements and company policies.
Ensure compliance with healthcare regulations, coding standards (e.g., ICD-10, CPT), and company policies throughout the claims process.
Provide excellent customer service to policyholders and healthcare providers, addressing inquiries and resolving issues related to claims.
 Qualification &amp; Skills: <ul>
<li>Bachelor of Medicine, Bachelor of Surgery (MBBS), Nursing degree, or relevant medical degree from an accredited institution.</li>
<li>Experience in the relevant health insurance industry is preferred.</li>
<li>Minimum knowledge of computer skills, including proficiency in Excel and other relevant software applications.</li>
<li>Strong analytical, communication, and problem-solving skills.</li>
<li>Attention to detail and ability to work efficiently in a fast-paced environment.</li>
<li>Ability to prioritize tasks and meet deadlines effectively.</li></ul>

Senior claims officer

What You Do
<ul>
<li>Oversee the Claims Reconciliation Team s daily activities, setting clear productivity and quality targets, and regularly reporting progress to the Manager and Heads.</li>
<li>Generate comprehensive Monthly Management Reports detailing Reconciliation Status (both open and closed), including disputed and payable amounts, while emphasizing key insights and actionable recommendations.</li>
<li>Design and implement process improvements not only within reconciliation but also across related functions where issues arise, such as adjudication mistakes, system glitches, unclear rejection reasons, timing, and technical errors.</li>
<li>Lead coaching and feedback sessions with both internal and external stakeholders to align on reconciliation requirements.</li>
<li>Organize ongoing training and development programs to boost team expertise and capabilities.</li>
<li>Establish performance objectives and track team progress to maintain exceptional accuracy and efficiency in reconciliation.</li>
<li>Create and execute strategies that optimize reconciliation workflows and enhance operational efficiency.</li>
<li>Ensure all reconciliation activities strictly comply with internal policies, external regulations, and industry standards.</li>
<li>Stay informed on relevant regulations and enforce compliance within the team.</li>
<li>Provide direct feedback to our Claims Medical team to improve the overall process.</li>
<li>Perform other ad hoc duties as neede</li>
</ul>
What You Bring
<ul>
<li>Bachelor s degree preferred in Medical fields, Finance, Business Administration, Insurance, or related areas.</li>
<li>At least 5 years of experience in claims reconciliation, finance, accounting, or similar fields.</li>
<li>Demonstrated success in managing and resolving complex claims challenges.</li>
<li>Excellent analytical and problem-solving abilities.</li>
<li>High attention to detail and precision.</li>
<li>Skilled in financial software and reconciliation tools.</li>
<li>Strong communication and interpersonal skills.</li>
<li>Proven ability to lead, inspire, and develop teams.</li>
<li>Familiarity with applicable regulations and industry standards.</li>
<li>Hybrid work option available based on business needs.</li>
</ul>

Reconciliation Team Lead

Key Responsibilities/What You DoReview and assess medical claims for both inpatient and outpatient services to determine coverage eligibility and compliance with policy terms.Validate Diagnosis-Related Group (DRG) coding for inpatient admissions using ICD-10-CM and CPT standards, ensuring alignment with clinical documentation.Apply thorough knowledge of UAE healthcare billing regulations, including DHA, DOH, and MOH guidelines, to ensure claims meet local compliance standards.Identify and rectify incomplete or inaccurate claim submissions. Ensure all required documentation is present and properly coded aligning with policy guidelines.Notify payers regarding claims that exceed predefined financial thresholds, ensuring timely communication and resolution.Track and maintain both quantitative (volume) and qualitative (accuracy) metrics for claims processing.Achieve assigned daily processing targets while maintaining high levels of accuracy and efficiency.Collaborate with internal departments to resolve claim-related queries.Perform other responsibilities as assigned by the department lead, in line with the scope of the role.Key Benefits/What We OfferOur employees play an integral part in our success as a business. We appreciate that each of our employees are unique and have unique needs, ambitions and we enjoy being a part of their journey.We are there to empower and encourage you with your personal and professional development ensuring that you take control by offering a large variety of courses and targeted development programs. All that in a global environment where international mobility and career progression are encouraged. Caring for your health and wellbeing is key priority for us. This is why we build Work Well programs to providing you with peace of mind and give the flexibility in planning and arranging for a better work-life balance.Allianz Group is one of the most trusted insurance and asset management companies in the world. Caring for our employees, their ambitions, dreams and challenges, is what makes us a unique employer. Together we can build an environment where everyone feels empowered and has the confidence to explore, to grow and to shape a better future for our customers and the world around us.We at Allianz believe in a diverse and inclusive workforce and are proud to be an equal opportunity employer. We encourage you to bring your whole self to work, no matter where you are from, what you look like, who you love or what you believe in.We therefore welcome applications regardless of ethnicity or cultural background, age, gender, nationality, religion, disability or sexual orientation.

J.S. Held

<div>Company Description 
Are you looking to join an organization that is growing and dynamic? What about a high-energy, collaborative environment that rewards hard work?
J.S. Held is a global consulting firm that combines technical, scientific, financial, and strategic expertise to advise clients seeking to realize value and mitigate risk. Our professionals serve as trusted advisors to organizations facing high stakes matters demanding urgent attention, staunch integrity, proven experience, clear-cut analysis, and an understanding of both tangible and intangible assets. The firm provides a comprehensive suite of services, products, and data that enable clients to navigate complex, contentious, and often catastrophic situations. 
Job Description 
The Candidate will primarily be involved in delivering claims consulting and dispute resolution services to our clients.
An individual is required who can show initiative, perform advanced data research, manage client relations and deliver to tight deadlines. This role will involve frequent client interaction and will require the successful candidate to prepare and make presentations to communicate results. It is preferred that the individual has previous experience in providing consultancy services on substantial and/or complex disputes in quantum related matters. The candidate may be supporting lead experts in formal dispute processes. They should be able to demonstrate experience in writing expert reports to a high level and have strong industry experience.
We anticipate that the successful candidate will have a good academic record and be able to demonstrate how they have distinguished themselves within their chosen field. They will be expected to work collaboratively with the team and deliver commissions under high pressure and to the client&rsquo;s satisfaction. We expect the individual will be able to contribute to business development through networking and marketing activities.
Job Responsibilities<ul><li>
Select appropriate analysis methodologies with guidance of manager, assist in Stage 1 commission reviews and identifying claim strategy</li><li>
Demonstrate ability to deliver concise and compelling event chronologies, draft completed sections of Claim Reports in your 1st Language</li><li>
Utilise appropriate structure and format of Report</li><li>
Peer review, critique and edit all subordinates work involved in commission</li><li>
Manage allocated staff on any given assignment, mentor junior staff</li><li>
Provide real time feedback on work product and other activities to allocated resources and upstream to manager, ensure allocated Commission elements are completed on time and on budget</li><li>
Assist in preparation of bi-weekly reports to client, ensure team timesheets are timely and accurate.</li><li>
Ensure Invoicing is timely and accurate and assist accounts team in recovering payment of fees.</li><li>
Engage in BD activities as requested by the BD Director, willing to draft articles for publishing</li><li>
Regularly attend marketing &amp; networking events</li><li>
Proactively assist in seeking out new work opportunities for the business</li></ul> 

Qualifications 
Qualifications<ul><li>
1st degree in construction or engineering subject</li><li>
2nd degree in legal or construction management subject</li><li>
Some training in dispute resolution matters</li></ul>
Required experience<ul><li>
5 years+ period of employment in leading international contracting organisation or owner organisation with international project portfolio</li><li>
3 years + period of employment delivering consulting services or high end internal claims preparation / defence experience</li><li>
Relevant claim preparation / defence experience</li><li>
Awareness of importance of work winning and client network</li></ul> 

Additional Information 
Some of the Benefits We Have Include
J.S. Held understands all of our employees are people and sometimes life needs flexibility. We work to always provide an environment that best supports and suits our team&rsquo;s needs.<ul><li>Our flexible work environment allows employees to work remotely when needed</li><li>Generous Annual Leave Policy</li><li>Comprehensive Medical Insurance</li></ul>
Other Duties
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.
By submitting your application, you acknowledge that you have read the J.S. Held Online Privacy Notice and hereby freely and unambiguously give informed consent to the collection, processing, use, and storage of your personal information as required and described therein.
Please explore what we&rsquo;re all about at www.jsheld.com.
EEO and Job Accommodations
We embrace diversity and our commitment to building a team and environment that fosters professional and personal enrichment is unwavering. We are greater when we are equal!
J.S. Held is an equal opportunity employer that is committed to hiring a diverse workforce. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected Veteran status, age, or any other characteristic protected by law.
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Director

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577 claims analyst jobs IN Dubai

Accounts Executive - Claims

Medical Claims Senior Assessor

Reimbursement Senior Assessor

Senior claims officer

Reconciliation Team Lead

Medical Claims Senior Assessor

Director