Medical insurance specialist
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Key skills for this role
About the Role
Dubai Corporation for Ambulance Services is seeking a Medical Insurance Specialist to develop corporate insurance policies, analyze claims revenue, and improve medical billing processes.
Key Skills for This Role
Responsibilities
- Develop and enhance corporate plans, policies, procedures, and KPIs for insurance claims management
- Provide technical consultation during development of insurance claims systems and applications
- Develop corporate medical services pricing policy in collaboration with relevant units
- Analyze insurance claims revenue growth trends and prepare periodic reports
- Analyze reasons for rejected insurance claims and develop solutions to improve medical documentation and coding
- Conduct periodic measurement of quality indicators related to medical billing and motor vehicle accident billing
- Process and reconcile rejected medical insurance and motor vehicle accident claims with insurance companies
- Provide technical support and guidance to Insurance Claims Officers and Medical Coding Officers
Requirements
- Master's degree with minimum 3 years of experience in Medical Insurance or related field
- Bachelor's degree with minimum 5 years of experience in Medical Insurance or related field
- Knowledge of Dubai Health Insurance Authority laws and regulations
Full Job Posting
Responsibilities
- Develop and enhance corporate plans, policies, procedures, and Key Performance Indicators (KPIs) for insurance claims management in accordance with the laws and regulations of the Dubai Health Insurance Authority.
- Provide technical consultation during the development of insurance claims systems and applications to enhance revenue generation and operational productivity.
- Develop the corporate medical services pricing policy in collaboration with relevant organizational units, ensuring compliance with the applicable laws and regulations in the Emirate of Dubai.
- Analyze insurance claims revenue growth trends and prepare periodic reports for the direct supervisor.
- Analyze the reasons for rejected insurance claims, develop innovative solutions to improve medical documentation and coding practices, and recommend system enhancements based on the findings.
- Conduct periodic measurement of quality indicators related to medical billing and motor vehicle accident billing processes in accordance with the regulations of the Health Insurance Authority.
- Process and reconcile rejected medical insurance and motor vehicle accident claims with insurance companies and prepare detailed reports on the outcomes.
- Provide technical support and guidance to Insurance Claims Officers and Medical Coding Officers in the performance of their duties.
Qualifications
- Master's Degree: Minimum 3 years of experience in Medical Insurance or a related field.
- Bachelor's Degree: Minimum 5 years of experience in Medical Insurance or a related field.
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