Fakeeh University Hospital Quality jobs

ABOUT US
Fakeeh Health is a pioneering healthcare group brought to the UAE by the esteemed founders of Fakeeh Care Group, KSA . With a strong legacy in clinical excellence, research & innovation, and academic integration, Fakeeh Health stands as a testament to our unwavering commitment to delivering holistic, high-quality, and accessible healthcare.

Fakeeh Health includes a network of patient-focused facilities led by our flagship, Fakeeh University Hospital , where Person-Centered Care (PCC) guides both patient and employee experiences. As a Planetree-aligned organization, we foster a supportive and empowering work culture. Our network also includes Fakeeh MediCenters across Dubai for accessible primary care, the tech-enabled Fakeeh Smart Clinic for hybrid physical and virtual care, and Fakeeh DaySurge , focused on minimally invasive, same-day procedures.

Aligned with our organizational values and PCC goals, we value professionals who bring experience in community engagement or corporate social responsibility (CSR), as such backgrounds reflect our shared commitment to meaningful social impact and community upliftment.

JOB PURPOSE:
To ensure efficient management and resolution of claims denials and reconciliation for cash and credit patients, focusing on timely, accurate, and cost-effective processes in alignment with established guidelines.

KEY RESPONSIBILITIES AND DUTIES:
Reviews adjudicated claims for accuracy and final resolution.
Issues adjusted, corrected, or rebilled claims to insurance companies as needed.
Analyzes claims denials and performs necessary appeals to secure appropriate reimbursement.
Submits insurance appeals in a timely manner and follows up to ensure receipt and processing by insurers.
Communicates directly with payers to resubmit denied claims, underpaid claims, or claims processed inaccurately.
Identifies, documents, and reports trends in recurring denials, suggesting process improvements or system edits to prevent future issues.

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Oversees Medicaid audits and ensures all required documentation is provided.
Reviews and prepares monthly system reports for leadership, highlighting key trends and updates.
Prepares an analytical summary report identifying areas of concern by dollar amount, claim volume, and new denials.
Tracks the improvement of targeted denials once process or system edits have been implemented to reduce or prevent future denials.
Collaborates with other departments to ensure maximum productivity and efficient resolution of denials.
Other duties as assigned within the scope of the job.

Experience:
Bachelor’s degree in Life Sciences, Nursing, Paramedical, or related medical field.

Certified medical coder (CPC, CCS, CPMA – AAPC/AHIMA preferred).

1–2 years of hospital claims resubmission experience in Dubai/Abu Dhabi.

3 years of experience in denial management, claims reconciliation, revenue cycle management or a related field.

Strong experience in denial management, appeals, and insurance audits.

Knowledge of ICD-10, CPT, HCPCS, DRG, and DHA billing systems.

Good skills in Microsoft Excel and office applications.

Strong analytical, communication, and problem-solving skills.

Responsible for denied claim review, resubmission, compliance, documentation tracking, and coordination with physicians/coders for supporting documents.

OTHERS:
The job description is subject to periodic review and may be updated as necessary. All job descriptions must be reviewed every 3 years or more often as deemed applicable to ensure they remain relevant.

COMPETENCIES:
Adaptability & Resilience
Accountability & Role Understanding with Accreditation Knowledge
Teamwork and Relationship Building with Cultural Alignment
Talent Management and Development
Compassionate and Effective Communication