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Insurance Company

Davidson Management Consultants have been mandated to recruit a Medical Claims Processor OP for their client which is a Insurance Company in Abu Dhabi UAE We are looking for candidates Allied Healthcare professionals like Pharmacist Nurses Physiotherapists etc with a minimum of 2 years of work experience a Medical Claims Processor OP in Abu Dhabi Candidates without UAE work experience as a Medical Claims Processor OP would not qualify for this vacancy Salary upto AED per month Company Profile Davidson Management Consultants are a leading recruitment agency in Dubai specializing in leadership and healthcare recruitment The healthcare recruitment services cover recruitment and executive search services offered to hospitals medical centers and medical universities Our healthcare search consultants assist clients in recruiting allied healthcare professionals like sonographers occupational therapists and hygienists and doctors for all recognized medical specialties and subspecialties like Obstetrics and Gynecology Neonatology Pediatrics Urogynecology Maternal Fetal Medicine Gastroenterology Cardiology and Orthopedics etc

Medical Claims Processor OP

NMC Health plc

<div><ul><li><div>The Resubmission Officer will be responsible for filing and tracking insurance claims, process insurance and disability claims in a timely manner.
</div></li><li><div>Process the Resubmission of rejected claims on the system, follow up with respective doctors for justification if necessary and prepare them for resubmission.
</div></li><li><div>Ensure that all concerned teams such as Patient Admin staff, coders, doctors are updated on time with the rejections and corrective action is taken to avoid such instances in future.
</div></li><li><div>Submit the claims with proper codes and format to insurance companies within the stipulated time.</div></li></ul></div>
 <div><ul><li><div>The Resubmission Officer will be responsible for filing and tracking insurance claims, process insurance and disability claims in a timely manner.
</div></li><li><div>Process the Resubmission of rejected claims on the system, follow up with respective doctors for justification if necessary and prepare them for resubmission.
</div></li><li><div>Ensure that all concerned teams such as Patient Admin staff, coders, doctors are updated on time with the rejections and corrective action is taken to avoid such instances in future.
</div></li><li><div>Submit the claims with proper codes and format to insurance companies within the stipulated time.</div></li></ul></div>
 <div>Minimum of 1 years of experience in the Insurance Department.
Knowledge of Claims Resubmission, Spreadsheets, and Software Modules.
Skills in Current Procedural Terminology (CPT) Coding.
Must have CPC certification</div>

Submission & Resubmission Officer

<div>3.1 Review and Audit Medical Claims to ensure their accuracy.
3.2 Resubmission of rejected claims
3.4 Ensure that the agreed price list and provider manual from insurance companies are followed for billing the service to the respective payers
3.5 Ensure that the Billing officers are updated on time with the rejections and corrective action is taken to avoid such instances in future
3.6 Handling the Resubmission of rejected claims, follow up with respective doctors for justifying the claims if necessary and prepare them for resubmission.
3.7 Submit the claims with proper codes and format to insurance companies within the stipulated time.</div>
 <div><ul><li>Review and Audit Medical Claims to ensure their accuracy.
 </li><li>Resubmission of rejected claims
 </li><li>Ensure that the agreed price list and provider manual from insurance companies are followed for billing the service to the respective payers
 </li><li>Ensure that the Billing officers are updated on time with the rejections and corrective action is taken to avoid such instances in future
 </li><li>Handling the Resubmission of rejected claims, follow up with respective doctors for justifying the claims if necessary and prepare them for resubmission.
 </li><li>Submit the claims with proper codes and format to insurance companies within the stipulated time.</li></ul></div>
 <div><ul><li>Medical/Nursing graduate from a recognized university.
</li><li>Experience in Insurance Claims Resubmission
</li><li>Experience in Medical Coding is preferable.
</li><li>Excellent command of oral and written English.</li></ul></div>

Medical Auditor

SIDC

Hiring Dental Insurance Clerk (1)Work Location: Abu Dhabi, Western RegionKey Responsibilities:<ul><li>Coordinate with third-party insurance companies to obtain pre-authorization and claim approvals for dental procedures.</li><li>Verify patient insurance coverage and eligibility for dental services.</li><li>Review treatment plans and submit accurate insurance pre-approvals.</li><li>Communicate effectively with patients, dentists, and insurance providers regarding coverage and claims.</li><li>Maintain accurate records of insurance correspondence, approvals, and denials.</li><li>Assist in resolving insurance-related inquiries or discrepancies.</li></ul>Requirements:<ul><li>Proven experience in dental insurance processing or healthcare administration.</li><li>Strong knowledge of dental procedure coding (CDT) and terminology.</li><li>Familiarity with insurance policies, pre-authorization procedures, and claims submission.</li><li>Excellent organizational and communication skills.</li><li>Attention to detail and ability to handle confidential patient information professionally.</li><li>Proficiency in Microsoft Office and dental practice management software.</li></ul>Preferred:<ul><li>Experience working in a dental clinic or hospital setting in Abu Dhabi.</li></ul>Job Type: Full-timePay: AED2,500.00 - AED3,000.00 per month

Dental Insurance Clerk for Western Region Branch

Fatorah Insurance Claims Settlement L.L.C

Job Title: Quality Audit AssociateCompany: Accumed Location: UAEAccuMed is seeking a Quality Audit Associate to ensure accuracy in clinical coding and claims processing. Only candidates with Abu Dhabi experience will be considered.Key Responsibilities:<ul><li>Conduct retrospective and concurrent audits of coded insurance claims</li><li>Ensure compliance with guidelines and international coding standards</li><li>Identify inconsistencies in claims data and provider/payer requirements</li><li>Analyze payer denials to determine root causes</li><li>Provide feedback and training to Clinical Coding and RCM teams</li><li>Maintain accurate audit trackers and documentation</li></ul>Requirements:<ul><li>Bachelor's degree in medical field or science</li><li>Coding certification from AAPC or AHIMA (required)</li><li>2-3 years of medical claims auditing experience</li><li>Must have Abu Dhabi insurance experience</li><li>Expert knowledge of ICD-10-CM/PCS, CPT coding systems</li><li>Strong understanding of medical terminology and anatomy</li></ul>Performance Metrics:<ul><li>97%+ accuracy in audit findings</li><li>Communication of audit feedback within 48 hours</li><li>20% improvement in audit program effectiveness</li></ul>Join our quality-focused team! Apply now.Note: Only candidates with Abu Dhabi insurance experience will be considered.Job Types: Full-time, PermanentPay: AED1,000.00 - AED2,000.00 per month

Quality Audit Associate

Transguard Workforce Solutions

<div>
 
 
 Transguard Workforce Solutions
 
 is the UAE&rsquo;s leading provider of unique and innovative HR solutions. With a decade of experience in the region and a team that possesses extensive knowledge of the market, we provide a fully integrated HR solution.
 
 
 We are currently recruiting a
 
 Supervisor &ndash; Engineering &amp; Liabilities Claims (Non-Marine &amp; Energy)
 
 for our client based in Abu Dhabi, UAE.
 
 
 
 
 
 
 Job Purpose:
 
 
 
 The job holder is responsible for supervising and implementing claims management strategies for Engineering &amp; Liabilities Claims (Non-Marine &amp; Energy - Direct). This includes overseeing a team of senior officers to ensure claims are processed promptly, accurately, and in compliance with insurance policies, company standards, and regulatory guidelines.
 
 
 
 
 
 
 Job Responsibilities:
 
 
 
 
 1.Policy &amp; Compliance:
 
 
 <ul>
 <li>
 Review and recommend updates to claims policies and procedures.
 </li>
 <li>
 Ensure compliance with rules, regulations, and procedural requirements.
 </li>
 <li>
 Communicate policies and procedures effectively across the team.
 </li>
 </ul>
 
 
 2.Claims Operations:
 
 
 <ul>
 <li>
 Supervise claim registration, processing, and reserve creation.
 </li>
 <li>
 Review claims processed by senior officers for accuracy in deductibles and limits.
 </li>
 <li>
 Evaluate survey reports and assessments.
 </li>
 <li>
 Ensure timely and accurate responses to claims queries within SLA timelines.
 </li>
 <li>
 Monitor claim documentation, investigation, evaluation, negotiation, reserving, and settlement.
 </li>
 <li>
 Analyze claim trends and support strategy development to address adverse patterns.
 </li>
 <li>
 Support litigation processes and draft legal correspondence when required.
 </li>
 <li>
 Maintain and update physical and electronic claim files.
 </li>
 <li>
 Review and validate settlement payments and denials.
 </li>
 <li>
 Ensure timely reporting to management and internal stakeholders.
 </li>
 <li>
 Conduct claims ageing analysis and monitor unsettled claims.
 </li>
 <li>
 Manage external loss adjusters and surveyors.
 </li>
 <li>
 Support training and development initiatives within the team.
 </li>
 </ul>
 
 
 3.Claims Rejection &amp; Investigation:
 
 
 <ul>
 <li>
 Review declined claims and ensure proper communication with clients/brokers.
 </li>
 <li>
 Investigate complex and suspicious claims and provide recommendations.
 </li>
 <li>
 Ensure technical justification for all claim rejections.
 </li>
 <li>
 Implement dual-check processes within the team.
 </li>
 </ul>
 
 
 4.Continuous Improvement:
 
 
 <ul>
 <li>
 Identify opportunities for process and system improvements.
 </li>
 <li>
 Support development of tools for efficient claims settlement.
 </li>
 <li>
 Align improvements with market needs and approved strategies.
 </li>
 </ul>
 
 
 5.Customer Satisfaction:
 
 
 <ul>
 <li>
 Ensure high standards of customer service.
 </li>
 <li>
 Address claim-related queries promptly to enhance client satisfaction.
 </li>
 </ul>
 
 
 
 
 
 Key Performance Indicators (KPIs):
 
 
 <ul>
 <li>
 Adherence to Turnaround Times (TATs)
 </li>
 <li>
 Nil actionable or aged claims
 </li>
 <li>
 Increased claims settlement and recovery ratios
 </li>
 <li>
 Reduced excess payouts and erroneous payments
 </li>
 <li>
 Improved response times and reduced customer complaints
 </li>
 <li>
 Effective performance monitoring of loss adjusters/surveyors
 </li>
 <li>
 Successful implementation of process improvements
 </li>
 </ul>
 
 
 
 
 
 Job Requirements:
 
 
 <ul>
 <li>
 Bachelor&rsquo;s Degree in relevant field
 </li>
 <li>
 Native Arabic Speakers required
 </li>
 <li>
 Diploma in Insurance or relevant certification - preferred
 </li>
 <li>
 4&ndash;5 years of relevant experience in Engineering &amp; Liabilities Claims, including 2-4 years in a supervisory role
 </li>
 </ul>
 
 
</div>

Supervisor – Engineering & Liabilities Claims (Non-Marine & Energy)

Modon

<div>
 
 
 
 Job Purpose
 
 
 
 
 The purpose of this role is to manage a Group-wide insurance management function that ensures Modon Holding and its subsidiaries are adequately protected against insurable risks across all geographies and business activities.
 
 
 
 
 
 The Group Insurance Manager will develop and govern Modon&rsquo;s corporate insurance strategy, ensuring that policies are cost-effective, risk-aligned, and compliant with UAE and host-country regulations. This role is responsible for overseeing the entire lifecycle of the Group&rsquo;s insurance portfolio. The Insurance Manager will act as the principal internal advisor on insurance matters and play a central role in interfacing with brokers, insurers, project managers, legal counsel, procurement teams, and segment operations.
 
 
 
 
 
 The job holder ensures that all Modon assets, people, and liabilities are covered through robust insurance programs. The role also focuses on eliminating uninsured exposures and embedding a proactive insurance culture aligned with Modon&rsquo;s broader risk and resilience frameworks.
 
 
 
 
 
 
 
 Roles, Responsibilities, Duties
 
 
 
 <ul>
 <li>
 Design and lead Modon&rsquo;s Group-wide corporate insurance program, ensuring alignment with enterprise risk appetite, strategic objectives, and regulatory requirements.
 </li>
 <li>
 Oversee placement, renewal, and administration of all insurance policies, including but not limited to: Property All Risk, Contractors All Risk (CAR), Business Interruption (BI), Cyber, D&amp;O, Public Liability, Employer&rsquo;s Liability, Workmen Compensation, Political &amp; Terrorism Risk, Machinery Breakdown, and Marine Cargo.
 </li>
 <li>
 Develop and maintain the Group Insurance Policy, governance framework, and standard operating procedures (SOPs) across Holding and Segments.
 </li>
 <li>
 Manage relationships with insurance brokers and underwriters, lead tender processes, assess service levels, and negotiate terms to ensure optimal coverage and pricing.
 </li>
 <li>
 Act as the central internal advisor for all insurance-related queries, including contractual risk transfer, insurance clauses in commercial agreements, and vendor/tenant compliance.
 </li>
 <li>
 Maintain a centralized insurance register, including policies, binders, certificates of insurance (COIs), renewal schedules, and claims logs.
 </li>
 <li>
 Oversee the full claims lifecycle &mdash; from notification and documentation to loss adjustment, negotiation, and settlement &mdash; including escalations.
 </li>
 <li>
 Monitor regulatory compliance with UAE Insurance Authority, ADGM/DED regulations, and foreign insurance regulators where Modon operates.
 </li>
 <li>
 Identify, assess, and advise on expiring or lapsed insurance policies, and recommend renewal strategies or corrective actions
 </li>
 <li>
 Support internal and external audits, assurance reviews, and Board/executive-level reporting on insurance performance, exposure, and claims.
 </li>
 <li>
 Provide insurance input into major projects, developments, and international ventures, ensuring coverage during construction, operations, and handover.
 </li>
 <li>
 Drive continuous improvement initiatives to enhance risk-transfer efficiency, minimize uninsured exposures, and align insurance with evolving operational risks.
 </li>
 </ul>
 
 
 
 
 
 
 Qualification
 
 
 
 <ul>
 <li>
 Bachelor&rsquo;s degree in insurance, Business Administration, Finance, or Risk Management (Master&rsquo;s preferred).
 </li>
 <li>
 Professional insurance qualifications such as ACII, CPCU, ARM, or CRM.
 </li>
 </ul>
 
 
 
 
 
 
 Experience
 
 
 
 <ul>
 <li>
 Minimum of 7&ndash;10 years of progressive experience in insurance management, with at least 2 years in the UAE or GCC region.
 </li>
 <li>
 Proven experience managing complex corporate insurance portfolios across multiple jurisdictions and business segments.
 </li>
 <li>
 Strong track record in handling diverse lines of insurance, including: Property All Risk, CAR/EAR, Public Liability, D&amp;O, Cyber, Business Interruption, Employer&rsquo;s Liability, Political Risk, and Marine Cargo.
 </li>
 <li>
 Demonstrated ability to lead end-to-end insurance processes, from coverage design and broker engagement to policy renewal and claims settlement.
 </li>
 <li>
 Familiarity with regulatory compliance in UAE (Insurance Authority, ADGM/DED) and host countries (e.g., Egypt, Morocco, KSA).
 </li>
 <li>
 Experience in reviewing insurance clauses in contracts (tenants, contractors, vendors, JV agreements).
 </li>
 <li>
 Experience engaging with brokers, underwriters, project teams, legal, procurement, and finance stakeholders.
 </li>
 <li>
 Prior exposure to insurance within real estate, infrastructure, hospitality, or publicsector conglomerates is highly desirable
 </li>
 </ul>
 
 
 
 
 
 
 Competencies
 
 
 :
 
 <ul>
 <li>
 Strong knowledge of policy structures, risk transfer methods, and regulatory frameworks.
 </li>
 <li>
 Ability to assess exposures, interpret claims data, identify gaps, and optimize coverage.
 </li>
 <li>
 Clear and confident communicator with internal stakeholders, brokers, and insurers.
 </li>
 <li>
 Competence in assessing insurance obligations in commercial contracts.
 </li>
 <li>
 Ability to manage multiple renewals, claims, and stakeholder engagements simultaneously.
 </li>
 <li>
 Strong interpersonal and stakeholder management skills; ability to work cross-functionally.
 </li>
 <li>
 Ability to align insurance strategy with broader risk, business continuity, and financial resilience objectives.
 </li>
 </ul>
</div>

Manager - Group Insurance

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