Reconciliation Associate
About the Role:
Accumed is seeking a meticulous and analytical Reconciliation Associate to join the Insurance Relationship Management team in Abu Dhabi. This role is ideal for healthcare professionals experienced in handling medical claims, performing reconciliations, and managing payer resubmissions to maximize revenue recovery for both OP (Outpatient) and IP (Inpatient) services.
Key Responsibilities:
The Reconciliation Associate will audit, analyze, and process all types of rejected claims and resubmit them with accurate justifications, ensuring 100% accuracy. You will proactively identify discrepancies, initiate timely appeals, and analyze claim rejection trends to provide recommendations for reducing recurring errors, all while ensuring compliance with UAE insurance protocols and coding standards.
Key Responsibilities:
- Audit and process all types of rejected claims (OP/IP) and resubmit them with accurate justifications.
- Identify denied or underpaid claims and initiate timely appeals in accordance with payer guidelines.
- Ensure all claims comply with coding rules, regulatory requirements, and UAE insurance standards.
- Maintain daily, weekly, and monthly reconciliation reports.
- Analyze claim issues and rejection trends, providing recommendations to reduce recurring errors.
Requirements:
- Bachelor’s Degree in Medicine (MBBS) or relevant medical field.
- Minimum 2 years of experience in medical claims resubmission and reconciliation within the UAE.
- Strong knowledge of UAE insurance protocols and claim processing guidelines.
- Understanding of reconciliation TAT, denial analysis, and claim verification processes.
- Excellent analytical, organizational, and communication skills.
Performance Expectations & Benefits:
- Competitive compensation package: AED 4000 to 7000.
- A key role in maximizing revenue recovery and maintaining smooth claims workflows in the healthcare insurance sector.