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.
Requirements
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.