About this role
The Claims Submission & Resubmission Officer is responsible for preparing, submitting, and monitoring medical claims to insurance companies to ensure accurate and timely reimbursement for hospital services.
Managerial
• Coordinate with relevant teams to ensure smooth insurance claims processing and workflow efficiency • Support communication between billing, coding, and insurance departments Technical
• Prepare and submit insurance claims for hospital services, ensuring accuracy in coding and patient information • Verify patient insurance eligibility and coverage prior to claim submission • Collaborate with billing and coding teams to ensure claims meet payer requirements • Monitor claim submission status and follow up on pending or unprocessed claims • Respond to insurance provider queries related to claim details • Maintain accurate records of submitted claims and their status updates • Stay updated with insurance policies, regulations, and claim submission protocols Quality and Safety
• Promote and maintain quality standards and support continuous quality improvement initiatives • Comply with safety, infection control, and quality control policies and procedures • Ensure adherence to environmental safety and infection prevention practices • Support clinical audit processes and reporting requirements • Communicate professionally with patients, families, and healthcare staff to obtain or clarify required information • Ensure documentation accuracy and compliance with hospital standards Continuous Education
• Participate in training sessions for staff, doctors, and nurses on equipment handling and related processes • Attend departmental programs, hospital committees, and staff meetings when required • Support orientation and training of new employees • Maintain professional knowledge through lectures, seminars, and online learning • Complete all required licensing, certification, and mandatory training within deadlines • Apply knowledge of relevant sciences such as anatomy, physiology, and related technical fields Occupational Safety and Health (OSH)
• Comply with all OSH and infection control policies, standards, and procedures • Report OSH hazards, incidents, near misses, and assist in risk assessments • Participate in OSH and infection control training, drills, and awareness programs • Follow safe working procedures and use appropriate personal protective equipment (PPE) • Adhere to emergency and evacuation procedures • Ensure proper waste management practices (reduce, reuse, recycle) • Participate in OSH audits and inspections to maintain standards Prevention and Control of Infection (PCI)
• Adhere to NMC PCI Policy and Strategy at all times • Maintain strict hand hygiene practices, including the 5 moments of hand hygiene • Follow “bare below the elbows” and environmental cleanliness standards
Qualifications & Licensure
• Bachelor’s degree in Healthcare Administration, Nursing, Paramedical, or a related field • Knowledge of medical coding, billing processes, and insurance claim management • Proficiency in hospital management systems and claims submission software • Strong organizational skills with excellent attention to detail • Excellent communication and problem-solving abilities Experience
• Relevant experience in healthcare administration, insurance claims, billing, or related functions (as applicable to role requirements) Specialist Certification
• Required: NA • Desired: NA Additional Requirements
• Self-motivated and able to work under pressure • Fluent spoken and written English (Arabic is advantageous but not mandatory) • Supportive, caring, and professional disposition • Strong adaptability and time management skills • Confidence in handling stressful situations • Strong IT competencies and computer literacy