
Denial Management Officer (STMC)
At a Glance
- Category
- 🏥 Healthcare
- Level
- Mid-Level
- Type
- Full-time
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The candidate is responsible for the identification, mitigation, and prevention of denials. This position is responsible for preparing clinical disputes based upon evidence base criteria documented within the respective medical record; the Specialist oversees and assists with day-to-day revenue cycle denial operations and supports process improvement initiatives for coding, billing, and collections activities associated with Denial Prevention. The candidate will conduct an analysis of denials and appeals, identifying and presenting both process improvements and revenue protection opportunities. The position will monitor UAE regulatory agencies to maintain up-to-date knowledge of changing rules and regulations affecting denial prevention and management practice. Additionally, will stay abreast of payer clinical policies to dispute denials and provide education for the prevention of denials.
Requirements
- •Ability to prepare clinical disputes based on evidence-based criteria
- •Knowledge of UAE regulatory agencies and rules
- •Ability to analyze denials and appeals
- •Knowledge of payer clinical policies
Responsibilities
- •Identify, mitigate, and prevent insurance denials
- •Prepare clinical disputes based on medical record evidence
- •Oversee day-to-day revenue cycle denial operations
- •Support process improvement for coding, billing, and collections
- •Conduct analysis of denials and appeals to identify revenue protection opportunities
- •Monitor UAE regulatory agencies for rule changes
- •Provide education for the prevention of denials
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SEHA is the Abu Dhabi National Health Insurance Company, responsible for public healthcare services in the Emirate. It manages a network of hospitals and clinics.
