Job Purpose
To support the design, coordination, and execution of wellness initiatives for corporate clients, while also managing the end-to-end processing and support of health insurance claims. This dual-function role ensures seamless service delivery in both wellness and claims, aligned with UAE insurance regulations and client expectations.
Key Responsibilities & DutiesWellness Program Support
· Assist in the design and coordination of wellness programs tailored to client needs.
· Facilitate wellness sessions including health screenings, fitness events, mental health workshops, and awareness campaigns.
· Maintain wellness calendars and manage the execution of scheduled events.
Client & Stakeholder Engagement
· Serve as the primary liaison between client HR teams, wellness service providers, and TPAs.
· Provide regular updates to clients on wellness engagement levels and claims performance.
· Address inquiries and escalate complex matters to relevant internal teams.
Wellness Monitoring & Reporting
· Track wellness program participation rates and compile performance reports.
· Analyze program effectiveness using KPIs and employee feedback.
· Support the preparation of dashboards and reports for client presentations.
Claims Handling & Adjudication Support
· Review claim submissions to ensure accuracy, completeness, and adherence to policy terms.
· Coordinate with TPAs and internal claims units for timely approvals, rejections, and clarifications.
· Support pre-authorization requests and follow up with healthcare providers for required documentation.
Claims Dispute & Resolution
· Investigate claim rejections and support the appeals process where applicable.
· Resolve client and employee concerns regarding delayed or denied claims.
· Escalate unresolved disputes to the Claims Supervisor or insurer.
Benefit Verification & Policy Support
· Verify coverage eligibility and benefit limits before processing high-value or complex claims.
· Educate client HR teams on policy inclusions, exclusions, and claims processes.
Vendor & Provider Coordination
· Schedule and manage services with external wellness vendors and healthcare providers.
· Foster strong working relationships with TPAs and clinics to ensure smooth claims processing and wellness delivery.
· Monitor service levels and turnaround times (TATs), raising concerns as needed.
Communication & Awareness
· Develop and distribute wellness and claims communication materials (e.g., posters, emails, FAQs).
· Promote employee awareness of wellness benefits and claims filing procedures through campaigns.
· Maintain wellness and claims documentation for internal and external communication.
Training & Knowledge Building
· Organize training sessions for employees and HR teams on wellness tools and insurance claim filing.
· Stay updated on industry trends, wellness innovations, and UAE insurance regulations.
· Contribute new ideas to improve employee engagement and claims efficiency.
Compliance & Audit Support
· Ensure compliance with DHA/HAAD regulations and internal claims and wellness procedures.
· Maintain accurate records of claims and wellness activities for audits.
· Assist in preparing compliance reports and responding to audit queries.
Daily DutiesPrimary
· Coordinate logistics for wellness activities and health events.
· Review and follow up on claim submissions and approvals.
· Maintain dashboards and reports for both wellness and claims performance.
· Handle basic client queries related to wellness and claims.
Secondary
· Create wellness content for newsletters and internal platforms.
· Support onboarding of new clients in wellness and claims-related areas.
· Participate in internal team initiatives aligned with HR and employee benefits.
Required Skills & CompetenciesTechnical Skills
· Knowledge of wellness program planning and insurance claims processing.
· Familiarity with UAE healthcare regulations (DHA/HAAD).
· Proficiency in Microsoft Office Suite (Excel, PowerPoint, Outlook).
· Experience with TPA portals or claims platforms (preferred).
Soft Skills
· Excellent communication and interpersonal skills.
· Strong time management and coordination abilities.
· Analytical mindset with attention to detail.
Core Competencies
· Teamwork: Collaborate with internal departments, TPAs, and clients effectively.
· Customer Focus: Deliver prompt and supportive responses to client wellness and claims needs.
· Problem Solving: Proactively address client issues and suggest improvements.
· Adaptability: Adjust to evolving client requirements and regulatory updates.
Educational QualificationsEssential
· Bachelor’s degree in Healthcare, Insurance, Human Resources, or a related field.
Preferred
· Certification in Health & Wellness, Insurance Claims Management, or similar.
· Training in Mental Health Awareness, Wellness Coaching, or Employee Engagement.
· CII, LOMA, or other insurance certifications (advantageous).
Knowledge Requirements
· Familiarity with corporate wellness strategies and mental health initiatives.
· Understanding of UAE health insurance practices, claims procedures, and compliance norms.
· Awareness of wellness ROI measurement and employee engagement techniques.
Job Type: Full-time
Pay: AED2,500.00 - AED4,000.00 per mont

Please refer the Job description for details