Assistant Claims Analyst American Hospital Dubai LLC

Coordinates with stakeholders to ensure effective communication and collaboration.

Performs claims analysis before submitting them to insurance companies.

Verifies each Inpatient (IP) and daycare bill, checking approval code, approval validity, approved amount, and billed amount.

Verifies high-value Outpatient (OP) bills, including network, approval code, approval validity, approved amount, and billed amount.

Coordinates with the Insurance coordinator to address missing or expired approvals, or bills without proper approval codes.

Coordinates with the back-end billing team for bill edits or encounter changes.

Coordinates with the back-end billing team regarding changes in approved and billed Diagnosis Related Group (DRG) amount, DRG code, and outlier amount.

Prioritizes accurate, thorough, and appropriate work.

Anticipates and prioritizes tasks to support department needs, adhering to policies and procedures.

Identifies and analyzes problems, takes action to resolve them, applies sound judgment, and takes responsibility for their resolution.

Supports hospital and department policies and procedures.