Al Futtaim Group

13 hours ago

Resubmission & Reconciliation Officer | Al Futtaim Health | Healthcare (AE)

✓ Verified Job

Canonical indexed version, validated from employer's careers page.

Source: Company careers pageValidated by: Fursa AI

Last checked: 13 hours agoStatus: Live

Job Summary

Manage insurance claim resubmissions and reconciliations for IP, OP, and Pharmacy claims by coordinating with payers, physicians, and internal teams. Ensure timely resubmissions with proper medical and technical justification in line with Insurance industry and DHA regulations. Track KPIs and denial root causes, maintain monthly and detailed denial reports, and help educate billing/approval and clinical teams to reduce future denials.

Location: United Arab Emirates

Workplace: Onsite

Employment Type: Full time

Job Function: Healthcare (Clinical, Medical, Wellness)

Seniority: Mid level

Key Responsibilities

•Update the Insurance Manager on unusual insurance denials/issues for resolution.
•Ensure timely resubmissions of eligible IP, OP, and Pharmacy claims with proper medical and technical justification.
•Communicate with payers for clarification at 1st and 2nd resubmission/reconciliation stages and interact with physicians for clinical justification.
•Analyze denial root causes by payer, collect feedback, and create system rules to prevent recurrence.
•Maintain resubmission KPI records and monthly reconciliations; keep detailed statements of technical vs medical denials and educate relevant teams to improve process flow.

Key Requirements

•Strong medical background to handle claim reconciliation efficiently.
•Certified professional coding certificate from a reputed institution.
•Certified medical/paramedical certificate.
•Minimum 3+ years’ experience in a similar role.
•Strong negotiation skills and strong soft skills.

Experience:3+ years

Skills:NegotiationCommunicationPresentationAnalytical skillsDecision-making

Certifications:Professional coding certificateMedical/paramedical certificate

Company Brief

Al Futtaim Group

Al-Futtaim Group is a diversified UAE conglomerate operating across automotive, retail, real estate, finance and services, representing 200+ global brands and serving customers across 20+ countries with over 40,000 employees.

Industry: Conglomerates & Holding Companies

Company Size: Enterprise (1,001+ employees)

Growth: Established Company

Funding: Bootstrapped

Headquarters: Dubai, United Arab Emirates

Glassdoor: 3.6

Website LinkedIn Glassdoor

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Al Futtaim Group

13 hours ago

Resubmission & Reconciliation Officer | Al Futtaim Health | Healthcare (AE)

✓ Verified Job

Canonical indexed version, validated from employer's careers page.

Source: Company careers pageValidated by: Fursa AI

Last checked: 13 hours agoStatus: Live

Job Summary

Location: United Arab Emirates

Workplace: Onsite

Employment Type: Full time

Job Function: Healthcare (Clinical, Medical, Wellness)

Seniority: Mid level

Key Responsibilities

•Update the Insurance Manager on unusual insurance denials/issues for resolution.
•Ensure timely resubmissions of eligible IP, OP, and Pharmacy claims with proper medical and technical justification.
•Communicate with payers for clarification at 1st and 2nd resubmission/reconciliation stages and interact with physicians for clinical justification.
•Analyze denial root causes by payer, collect feedback, and create system rules to prevent recurrence.
•Maintain resubmission KPI records and monthly reconciliations; keep detailed statements of technical vs medical denials and educate relevant teams to improve process flow.

Key Requirements

•Strong medical background to handle claim reconciliation efficiently.
•Certified professional coding certificate from a reputed institution.
•Certified medical/paramedical certificate.
•Minimum 3+ years’ experience in a similar role.
•Strong negotiation skills and strong soft skills.

Experience:3+ years

Skills:NegotiationCommunicationPresentationAnalytical skillsDecision-making

Certifications:Professional coding certificateMedical/paramedical certificate

Company Brief

Al Futtaim Group

Industry: Conglomerates & Holding Companies

Company Size: Enterprise (1,001+ employees)

Growth: Established Company

Funding: Bootstrapped

Headquarters: Dubai, United Arab Emirates

Glassdoor: 3.6

Website LinkedIn Glassdoor