About the job
Job Summary:
We are in search of a meticulous and proactive Billing & Insurance Coordinator to oversee the management of insurance eligibility, pre-authorizations, claims submissions, reconciliations, and patient billing processes. The ideal candidate will be instrumental in maintaining accurate revenue cycle management, ensuring compliance with UAE healthcare regulations, and facilitating a seamless financial experience for our patients. This position necessitates strong collaboration with clinical teams, front desk staff, insurers, and finance professionals.
Key Responsibilities:
1. Insurance Verification & Pre-Authorization:
- Confirm patient insurance eligibility, coverage limits, exclusions, and co-pay requirements prior to appointments.
- Secure and monitor pre-authorizations for consultations, diagnostic services, imaging, laboratory tests, and procedures.
- Work closely with clinicians to ensure that necessary medical documentation supports authorization requests.
- Communicate approvals, denials, and coverage details to patients and internal teams effectively.
2. Claims Submission & Processing:
- Prepare, review, and submit precise insurance claims in accordance with UAE payer requirements and coding standards.
- Ensure appropriate CPT/ICD coding coordination with clinical and medical records teams.
- Track claim status, follow up on pending claims, and promptly resolve rejected or denied claims.
- Maintain comprehensive documentation of submissions, resubmissions, and appeals.
3. Patient Billing & Collections:
- Generate patient invoices for co-payments, deductibles, and services not covered by insurance.
- Provide clear explanations of charges and payment responsibilities to patients.
- Process payments and keep accurate financial records.
- Assist in collections follow-up in a professional and patient-centered manner.
4. Revenue Cycle & Reconciliation:
- Reconcile daily billing reports with EMR and finance records.
- Collaborate with the finance department on revenue reporting and resolve discrepancies.
- Monitor KPIs related to claims acceptance rates, denials, and turnaround times.
- Identify areas for improvement in billing efficiency and reduction of revenue leakage.
5. Compliance & Regulatory Adherence:
- Ensure adherence to DHA regulations, insurance policies, and UAE healthcare billing standards.
- Safeguard the confidentiality of patient financial and medical information.
- Assist in internal audits and insurance audits as necessary.
6. Collaboration & Patient Experience:
- Engage with physicians, nurses, radiology, laboratory, and front desk teams to ensure a seamless workflow.
- Support transparent communication with patients regarding coverage, approvals, and financial obligations.
- Contribute to continuous improvement of administrative and operational processes.