About the Role

We are looking for an Associate, Reconciliation to handle rejected and underpaid healthcare claims, investigate the reasons for rejection, and process/resubmit claims accurately to maximize revenue recovery.

Key Responsibilities
- Review and process rejected and underpaid healthcare claims
- Investigate claim rejections and identify the root cause
- Prepare and process resubmissions and appeals within defined timelines
- Ensure claims comply with coding and insurance guidelines
- Review claims from both medical and insurance perspectives
- Identify payment discrepancies and revenue leakage
- Reconcile claims against remittances and processed entries
- Maintain daily production and quality targets
- Identify and report recurring rejection and payment trends
- Provide feedback to Team Leaders on rejection trends and process issues
- Ensure timely follow-up and resolution of outstanding claims
- Report any claim-related issues or observations that may impact the process




- Coordinate with internal and external teams to resolve claim issues
- Maintain proper documentation and professional communication
- Ensure compliance with UAE healthcare regulations, payer guidelines and internal SOPs

Requirements
- 3-5 years of experience in Medical Claims Processing in a UAE provider, payer or TPA environment
- Minimum 2 years of experience in Reconciliation / Resubmission
- Bachelors Degree in Medicine (MBBS) or any medical-related field
- Good knowledge of UAE insurance protocols
- Strong knowledge of HAAD, Riayati and DHA guidelines
- Knowledge of ICD and CPT is preferred
- Strong MS Excel and MS Office skills
- Good analytical and problem-solving abilities
- Ability to handle complex claims and identify appropriate resolutions
- Robust attention to detail and accuracy
- Good communication and coordination skills
- Ability to work independently and meet daily targets

📌 Reconciliation Officer (Chennai)
🏢 ACCUMED Practice Management Medical Billers
📍 Chennai