Specialist – Submission (Healthcare Claims)

About the role

The Specialist – Submission will ensure accurate and timely processing of insurance claims for Tawam Fertility Center. Working closely with the finance team, the role monitors compliance with insurer agreements and supports patients and clinics on financial inquiries.

Key responsibilities

• Monitor compliance with insurance company terms, contractual agreements and facility pricing structures.
• Assist in collecting, validating and processing outpatient and inpatient claims, including laboratory, radiology and pharmaceutical services.
• Check claim invoices, generate missing or incorrect invoices and enter each claim into the system.
• Prepare statements of accounts and respond to patient and clinic financial inquiries.
• Follow‑up claim submissions, resubmit rejected claims and ensure all insurance documents are correctly completed.
• Compare cancelled receipts with cashiers’ records to detect any irregularities.
• Provide customer service support and technical expertise on accounting issues.
• Participate in cross‑functional teams, develop procedure manuals and act as subject‑matter expert for inventory accounts and payment systems.

Required profile

• Minimum 6 years of progressive experience in a similar claims‑submission role.
• Experience working in a large healthcare facility is preferred.