Compliance Officer - Finance
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Key skills for this role
About the Role
Transguard Workforce Solutions seeks a Compliance Officer for a client in Abu Dhabi to ensure medical insurance operations comply with UAE regulations. The role requires 5-10 years of compliance experience and a background in currency exchange or insurance.
Key Skills for This Role
Responsibilities
- Interpret and map health insurance policies to internal SOPs
- Maintain Compliance Obligations Register and gap log
- Plan and document routine compliance audits
- Prepare regulatory submissions and respond to inspections
- Oversee TPA performance and outsourcing compliance
- Monitor medical claims for fraud, waste, and abuse
- Ensure medical data handling complies with data protection laws
- Conduct SOP and policy reviews across medical insurance operations
- Oversee resolution of medical claim disputes escalated to regulator
- Submit regulatory reports and renew health insurance licenses
Requirements
- Bachelor's in Business, Law, or Healthcare Management
- Minimum 5 10 years experience in Compliance roles, AML, Legal
- Background in Currency exchange industry or Insurance industry preferred
- Preferred Certifications: ICA or CFE
Full Job Posting
Job Purpose
- Ensure the Company’s medical insurance operations remain compliant with all applicable regulatory frameworks including Central Bank of the UAE, DHA, DOH, MOHAP.
Duties and Responsibilities
- Interpret and map prevailing Health Insurance policies to internal SOPs
- Maintain a Log of all Circulars & Directives and Compliance Obligations Register
- Plan and document routine compliance audits; maintain evidence repositories
- Prepare regulatory submissions and respond to DOH inspections
- Act as primary point of contact with health authorities
- Oversight of TPAs & Third Parties: SLAs, KPIs, audit rights
- Monitor medical claims for suspicious patterns (FWA)
- Ensure medical data handling complies with data protection laws
- Validate data flows with TPAs/IT for secure processing
- Audit medical insurance operations across all domains
- Oversee resolution of medical claim disputes escalated to regulator
- Submit reports to Regulators and conduct timely license renewals
Requirements
- Bachelor’s in Business, Law, or Healthcare Management
- Minimum 5 10 years experience in Compliance roles, AML, Legal
- Background in Currency exchange industry or Insurance industry preferred
- Preferred Certifications: ICA or CFE
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