Submission Officer - UAE, United Arab Emirates - Al-Futtaim

Al-Futtaim

Verified Company

UAE, United Arab Emirates

2 weeks ago

Posted by:

Ahmed Al-Mansouri

beBee Recruiter

Description

Established in the 1930s as a trading business, Al-Futtaim Group today is one of the most diversified and progressive, privately held regional businesses headquartered in Dubai, United Arab Emirates.

Structured into five operating divisions; automotive, financial services, real estate, retail and healthcare; employing more than 35,000 employees across more than 20 countries in the Middle East, Asia and Africa, Al-Futtaim Group partners with over 200 of the world's most admired and innovative brands.

Al-Futtaim Group's entrepreneurship and relentless customer focus enables the organization to continue to grow and expand; responding to the changing needs of our customers within the societies in which we operate.

By upholding our values of respect, excellence, collaboration and integrity; Al-Futtaim Group continues to enrich the lives and aspirations of our customers each and every day

About the role:

Timely submissions of claims.
Improve the quality of claims submission to achieve mínimal initial denials
The role also include stop revenue loss through monitoring and coordination with allconcerned stakeholders like preauthorization and coding team to facilitate timely closure of QMS related to claims coding clarification and codifications.

What you will do:

Ensure timely submissions of all eligible IP,OP and Pharmacy claims with proper medical and technical justification.
Internal Follow up for raised QMS to concerned branch.
Interacting with the physicians for the clinical justification of the claims
Ensure and work closely with the team on complex cases that need experience and specialist knowledge or technical IT support.
Work closely with Insurance Approvals and Claims resubmission Team to minimize the claims denials
Making sure that claim submissions are dealt with according to Insurance industry and DHA regulations.
Comply with submission KPI's (Key Performance Indicator), maintain a record of submission KPIs as and when required.
Educate billing/Approval team to enhance the process flow.
Ensures that targets are met within turnaround time and while maintaining quality and productivity.
Coordinate with CDI team to educate the physicians, and other paramedical team to ensure proper claims documentations.
Maintain accurate monthly data of claims submissions of each insurance company
Coordination with other business stakeholders to improve overall submission process efficiency.
Analysis of financial data related to revenue cycle, to identify defaulting payers and work with the concern department on corrective strategies to mitigate the financial risk/s.

Required skills to be successful:

Job-Specific Skills:

Strong medical background to handle reconciliation efficiently.
Strong Negotiation skills
Strong soft skills

Behavioural Competencies:

Excellent presentation and analytical skills
Good decisionmaking skills
Strong operational thinking skills
Strong dedication skills
Ability to work under pressure to achieve target

What qualifies you for the role:

Minimum Qualifications and Knowledge:

Certified professional coding certificate from reputed institution
Certified medical /paramedical certificate

Minimum Experience:

Minimum 3+ years' experience in a similar role. Proven experience in design and creative content development; strong trackrecord in translating creative ideas into visual displays

About Al-Futtaim Healthcare

We Hear Your Ambition.

For over 90 years, the Al-Futtaim Group has been bringing the world's leading brands of lifestyle watches, cars, home furnishings and fashion to the UAE.

The Group has now introduced a whole new way of holistic healthcare through HealthHub Clinics by Al-Futtaim, its multi-speciality chain of more than 20 clinics in Dubai with over 25 specialties offering the right combination of advanced diagnostics, proven medical expertise and specialised services.

What gives our clinics an edge is that as a part of the Al-Futtaim Group, you can expect world-class quality standards, with access to the best medical services and facilities within a healing environment.

It's a new way of healthcare that's designed to meet a patient's needs with a complete range of smart healthcare solutions.

As testimony to this, only recently, we've earned a rare milestone of being the only primary healthcare network in the UAE to receive the Gold Seal by a reputed international body:
Accreditation Canada.