Specialist – Submission (Tawam Fertility Center)

Job Overview

The Specialist - Submission at Tawam Fertility Center supports healthcare revenue-cycle operations by validating charges, preparing and submitting claims, monitoring insurer requirements and following up on rejected or unpaid claims. The role also handles financial enquiries and helps maintain accurate billing and accounting processes.

Key Responsibilities

• Monitor compliance with insurance-company terms, contractual conditions, facility pricing structures and patient-category rules.
• Assist with collecting, validating and processing inpatient and outpatient claims.
• Review laboratory, radiology, pharmaceutical and other outpatient services included in submitted claims.
• Check inpatient and outpatient invoices and identify missing, incorrect or inconsistent charges.
• Generate or regenerate missing and incorrect invoices and process claims accurately in the relevant system.
• Prepare statements of account and respond to financial enquiries from patients and specialty clinics.
• Follow up claim submissions with insurance companies and ensure all supporting documents are complete and correctly prepared.
• Review rejected, unpaid or incorrectly processed claims and coordinate resubmission where appropriate.
• Compare cancelled receipts with cashier records on a periodic basis and support financial-control procedures.
• Provide technical input on potential accounting or financial issues and escalate complex matters to management.
• Participate in cross-functional teams and contribute to the improvement of procedures, manuals and revenue-cycle processes.

Requirements

• Minimum 6 years of relevant progressive experience in a similar healthcare billing, claims or revenue-cycle role.
• Experience in a large healthcare facility is desirable.
• Strong understanding of medical claims, insurance requirements, billing and healthcare financial processes.
• Good analytical, reconciliation, communication and customer-service skills.
• Ability to work accurately with healthcare information systems and financial records.

Employment Details

• Company: Abu Dhabi Health Services Company- SEHA
• Location: Al Ain, Abu Dhabi, United Arab Emirates
• Employment Type: Full Time
• Industry: Hospitals and Health Care

How to Apply

Interested candidates can review the full vacancy details and apply through the provided LinkedIn application link.