RCM Coordinator – Pre‑Authorization & Claims Operations

About the role

The RCM Coordinator will manage pre‑authorization, claim submission and payer network activities across multiple Dubai facilities, ensuring timely approvals, accurate billing and compliance with insurance policies.

Key responsibilities

• Secure service approvals from patients’ insurance companies and meet turnaround times (outpatient within 24 hours, inpatient within 24‑48 hours).
• Submit electronic and physical claims for all facilities, generate XML files and troubleshoot the electronic claim system.
• Maintain and update the Approval Request Tracker, Insurance Master and tariff repository.
• Coordinate with laboratories, pharmacies, front‑office and hospital branches to ensure smooth workflow.
• Support payer onboarding, credentialing and contract maintenance, and act as the first point of contact for internal departments on network participation.
• Prepare weekly under‑dispatch reports, monitor vendor performance and escalate issues to the Claims Operations manager.
• Deliver training on insurance policies and procedures to patient administration, nurses and doctors.
• Escalate policy clarifications, IT concerns or claim discrepancies to the Pre‑Authorization Team Lead.

Required skills

• XML file creation and handling.
• Electronic billing and claim submission systems.
• CPT (Current Procedural Terminology) coding.
• HCPCS (Healthcare Common Procedure Coding System) coding.