Senior Officer - Insurance Services

About the role

Amana Healthcare, a long-term care and rehabilitation provider in the Middle East and GCC and part of the M42 network, is hiring a Senior Officer, Insurance Services in Abu Dhabi. The role reports to the Supervisor, Insurance Services and supports the finance and insurance teams with daily insurance activities such as authorization, submission, resubmission and processing of medical claims, in line with the hospital's insurance procedures and guidelines.

Key responsibilities

• Ensure accurate claims processing for insurance and corporate review, following contractual agreements for reimbursement.
• Coordinate with insurance companies on eligibility verification, payment approvals and reconciliation.
• Provide customer service support for insurance verification, eligibility and preauthorization.
• Liaise with staff so insurance information and benefits are entered on time, and verify claims compliance with billing guidelines.
• Train doctors and senior officers, and share insurance guidelines and procedures with front-line staff.
• Support other departments and payers in tracking payments, monitor receivables and reconcile remittance advice.
• Maintain records of claims correspondence with insurance and private or corporate businesses.
• Take part in training new staff, assist with internal and external audits, and help develop insurance guidelines and processes.
• Analyze claim adjustments, bad debt provisions and contractual allowances, and check accuracy of claim submissions and resubmissions.
• Coordinate billing clerks and utilization nurses on insurance claims, manage a collection desk for outstanding balances, and prepare claim reports for analysis.

Required profile

• Bachelor's degree in Finance, Accounting, Business Administration or a related field.
• 4-5 years of career experience.
• Experience in a finance, accounting or insurance environment within a healthcare facility.
• Familiarity with UAE insurance practices.