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

- Valuable analytical and problem-solving abilities

- Ability to handle complex claims and identify appropriate resolutions

- Strong 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