Job Description

Roles & Responsibilities

Insurance Empanelment and Contract Coordination
- Coordinates empanelment activities with insurance companies and TPAs for new facilities, services, and network expansions under the guidance of the Director – RCM.
- Assists in the preparation, coordination, and follow-up of contractual agreements with insurance companies and TPAs in line with approved terms.
- Ensures timely follow-up with insurers on empanelment status, contractual clarifications, and network confirmations.
- Coordinates with internal stakeholders to ensure agreed insurance terms and formalities are implemented accurately to minimize objections and delays.
Contract Administration and Documentation
- Maintains accurate, complete, and up-to-date records of all insurance contracts, agreements, and network documentation.
- Files and centrally documents insurance contracts and agreements with Finance while maintaining working copies for the RCM team.
- Tracks contract validity, amendments, renewals, and updates, escalating discrepancies or gaps as required.
- Ensures timely communication of contract-related updates to relevant stakeholders for correct operational implementation.
System Setup and Network Updates
- Coordinates with Finance and Billing teams to create and activate new Accounts Receivable (AR) accounts related to newly empaneled insurers or services.
- Supports insurance network and system updates in alignment with approved contract terms and payer requirements.
- Assists in validating that system configurations accurately reflect agreed insurance arrangements.
Policy Support, Training and Communication
- Prepares training and reference materials related to insurance products, eligibility rules, and network updates for Patient Relations and related teams.
- Supports periodic training and briefings to ensure operational teams understand insurance requirements and updates.
- Acts as a coordination point to ensure consistent interpretation and application of insurance policies across departments.
Operational Support and Compliance
- Applies functional and business knowledge of insurance operations to support compliance with insurer requirements and hospital policies.
- Prioritizes tasks effectively to meet departmental timelines and operational needs.
- Identifies and analyzes issues related to insurance coordination, supports resolution, and escalates when necessary.
- Ensures adherence to hospital and departmental policies, procedures, and documentation standards at all times.

Desired Candidate Profile

Bachelor’s Degree in Finance, Business Administration, Healthcare Management, or a related field

PROFESSIONAL EXPERIENCE:

Minimum of four (4) years of experience in insurance coordination, contract administration, revenue cycle support, or a related healthcare role.
Knowledge of hospital operations and basic revenue cycle concepts.
Knowledge of insurance empanelment, network management, and contract administration processes.
Knowledge of insurance documentation, compliance, and payer requirements.
Skills in coordination and professional communication with insurance companies, TPAs, and internal stakeholders.
Skills in documentation management, record keeping, and basic data analysis.
Skills in using Microsoft Office applications (Word, Excel, PowerPoint, Outlook).
Ability to manage multiple coordination tasks accurately and within deadlines.
Ability to analyze information, identify discrepancies, and escalate issues appropriately.
Ability to maintain confidentiality, attention to detail, and professionalism at all times.

Insurance Relationship Associate American Hospital Dubai LLC