Billing & Insurance Coordinator

Job Summary:

We are seeking a detail-oriented and proactive Billing & Insurance Coordinator to manage insurance eligibility, pre-authorizations, claims submission, reconciliation, and patient billing processes.

The successful candidate will play a critical role in ensuring accurate revenue cycle management, compliance with UAE healthcare regulations, and a seamless financial experience for patients. This role requires strong coordination with clinical teams, front desk staff, insurers, and finance.

Key Responsibilities

1. Insurance Verification & Pre-Authorization

• Verify patient insurance eligibility, coverage limits, exclusions, and co-pay requirements prior to appointments.
• Obtain and track pre-authorizations for consultations, diagnostic services, imaging, laboratory tests, and procedures.
• Coordinate with clinicians to ensure required medical documentation supports authorization requests.
• Communicate approvals, denials, and coverage details to patients and internal teams.

2. Claims Submission & Processing

• Prepare, review, and submit accurate insurance claims in compliance with UAE payer requirements and coding standards.
• Ensure correct CPT/ICD coding coordination with clinical and medical records teams.
• Monitor claim status, follow up on pending claims, and resolve rejected or denied claims promptly.
• Maintain accurate documentation of submissions, resubmissions, and appeals.

3. Patient Billing & Collections

• Generate patient invoices for co-payments, deductibles, and uncovered services.
• Provide clear explanations of charges and payment responsibilities to patients.
• Process payments and maintain accurate financial records.
• Support collections follow-up in a professional and patient-centered manner.

4. Revenue Cycle & Reconciliation

• Reconcile daily billing reports with EMR and finance records.
• Coordinate with the finance department on revenue reporting and discrepancies.
• Track KPIs related to claims acceptance rates, denials, and turnaround times.
• Identify opportunities to improve billing efficiency and reduce revenue leakage.

5. Compliance & Regulatory Adherence

• Ensure compliance with DHA regulations, insurance policies, and UAE healthcare billing standards.
• Maintain confidentiality of patient financial and medical information.
• Support internal audits and insurance audits when required.

6. Collaboration & Patient Experience

• Work closely with physicians, nurses, radiology, laboratory, and front desk teams to ensure seamless workflow.
• Support transparent communication with patients regarding coverage, approvals, and financial obligations.
• Contribute to continuous improvement of administrative and operational processes.

Qualifications & Experience

Required:

• Bachelor’s degree or diploma in Healthcare Administration, Finance, Medical Coding, or related field.
• Minimum 2–4 years of experience in healthcare billing and insurance coordination in the UAE.
• Strong understanding of UAE insurance providers, claim submission systems, and DHA billing regulations.
• Familiarity with ICD and CPT coding standards.
• Experience using EMR systems and insurance portals.

Preferred:

• Experience in specialty clinics (endocrinology, diabetes, metabolic health, cardiology).
• Knowledge of value-based care or integrated care models.
• Experience handling high-volume insurance coordination.

Skills & Competencies

• Strong attention to detail and accuracy.
• Excellent organizational and time-management skills.
• Problem-solving mindset with ability to manage claim rejections effectively.
• Strong communication skills (verbal and written).
• Professional, patient-centered approach.
• Ability to work in a fast-paced, multidisciplinary environment.