Reconciliation Analyst

Primary Responsibilities

• Audit, process, and resubmit rejected/underpaid claims after thorough investigation and justification.
  
• Identify discrepancies in medical & technical claim denials and appeal them within deadlines to maximize revenue.
  
• Ensure compliance with UAE insurance, HAAD, Riayati & DHA guidelines.
  
• Meet daily productivity and quality targets with high accuracy.
  
• Provide feedback on rejection trends to minimize future claim denials.
  
• Process high-value and critical error claims with due diligence and proper documentation.
  
• Train and audit claims of new joiners.
  
• Coordinate with internal and external teams to resolve claim-related issues.
  
• Maintain professional communication, ethical standards, and proper documentation in all processes.

Preferred candidate profile

• Bachelors Degree in Medicine (MBBS) or any bachelor’s degree in a medical field (mandatory).
  
• 3–5 years’ experience in medical claims processing with a provider/payer/TPA in the UAE.
  
• Minimum 2 years’ experience in handling resubmissions/reconciliation.
  
• Strong knowledge of UAE insurance protocols and coding guidelines.
  
• Proficiency in ICD, CPT codes, and medical auditing practices.
  
• Advanced proficiency in MS Office (especially Excel).
  
• Strong problem-solving, conflict-resolution, and analytical skills.
  
• Ability to meet deadlines, maintain accuracy (98%+) and ensure compliance with coding/business rules.
  
• Excellent communication and teamwork skills.