Insurance Resubmission Executive - Dubai, United Arab Emirates - Clinicare Samari Br of Imara Healthcare LLC

Clinicare Samari Br of Imara Healthcare LLC

Verified Company

Dubai, United Arab Emirates

2 weeks ago

Posted by:

Ahmed Al-Mansouri

beBee Recruiter

To update Insurance manager about unusual denial / issues from Insurance Companies for further discussion and resolution.

Ensure timely resubmissions of all eligible IP,OP and Pharmacy claims with proper medical and technical justification.
Communicating with the payers for any clarification regarding the rejected claims at 1st resubmission and 2nd resubmissionreconciliation stage.
Interacting with the physicians for the clinical justification on the rejected claims
Ensure and work closely with the team on complex cases that need experience and specialist knowledge or technical IT support.
Working closely with Insurance Approvals and Claims Submission Team to minimize the claims denials
Making sure that claim resubmissions are dealt with according to Insurance industry and DHA regulations.
Educate billing/Approval team to enhance the process flow.
Ensures that targets are met with in turnaround time and while maintain 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 resubmissions /reconciliations of each insurance company
Maintain a detailed statement of insurance denials segregated to technical denials and medical denials to facilitate the proper denial management plan and required training and documentation enhancement

Pay:
AED2, AED2,500.00 per month

Application Deadline: 06/06/2024

Clinic Receptionist