About this role
Overview
M42 delivers comprehensive healthcare services across the full continuum of care; from primary care to advanced specialty treatments. Leveraging cutting-edge health technologies and precision medicine, we ensure the highest standards of effectiveness, efficiency, and patient-centered outcomes. With a global presence spanning more than 480 facilities in 27 countries and a dedicated workforce of over 20,000 professionals, M42 is uniquely positioned to redefine the future of healthcare on a global scale.
Amana Healthcare is a leading long-term care and rehabilitation provider in the Middle East and GCC, and the region’s pioneer in post-acute care services. It offers comprehensive long-term care, post-acute rehabilitation, transitional care, and home healthcare. As part of the M42 network, Amana is dedicated to delivering high-quality, patient-centered care tailored to the needs of individuals requiring complex or extended recovery support.
The Officer, Insurance Service, reports to the Supervisor, Insurance Services, and is accountable for providing vital support to the finance and insurance teams in their daily insurance activities. This multifaceted role involves various responsibilities, including but not limited to handling authorizations, submissions, resubmissions, and processing medical claims. The Officer ensures that all insurance-related tasks are carried out in strict accordance with MH's relevant insurance procedures and guidelines. Their dedication and attention to detail contribute significantly to the smooth functioning of insurance operations, ultimately facilitating efficient patient care.
Responsibilities
- Ensure accurate and timely processing, review, submission, and resubmission of insurance and corporate claims in accordance with contractual terms, payer requirements, billing guidelines, and applicable regulatory standards.
- Coordinate insurance verification, eligibility, benefits, and preauthorization activities, providing timely support to patients, front-line staff, clinical teams, and other relevant stakeholders.
- Review claims for completeness, accuracy, and compliance, identifying discrepancies and coordinating with billing, utilization, and clinical teams to resolve issues that may affect reimbursement.
- Support revenue cycle and collection activities by monitoring outstanding balances, tracking payer payments, and following up on rejected, denied, delayed, or underpaid claims.
- Maintain accurate records and documentation relating to claims, payer correspondence, insurance approvals, corporate accounts, contractual requirements, and payment follow-up activities.
- Analyze claims adjustments, contractual allowances, bad-debt provisions, denials, and other relevant insurance data, and prepare reports to support performance monitoring and operational decision-making.
- Communicate insurance policies, payer requirements, and operational procedures to relevant staff, while contributing to the development and continuous improvement of insurance guidelines, workflows, controls, and processes.
- Maintain compliance with organizational policies, regulatory requirements, confidentiality, patient privacy, information security, and professional standards, while actively participating in meetings, performance evaluation processes, and continuous improvement initiatives.
Qualifications
- Bachelor’s degree in Finance, Accounting, Business Administration, Healthcare Administration, or a related field .
- 0–2 years of relevant experience , preferably in healthcare insurance, billing, finance, revenue cycle, or a related environment.
- Working knowledge of UAE health insurance practices , healthcare revenue cycle management, medical billing, collections, and third-party payer processes.
- Basic understanding of medical coding, claims processing, preauthorization, and insurance reimbursement procedures .
- Strong analytical, problem-solving, communication, and Microsoft Office skills , with proficiency in written and spoken English; Arabic is an advantage.