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Insurance Reimbursement Associate

3 months ago

Dubai, Dubai, United Arab Emirates Merck KGaA Full time
Work Your Magic with us


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Together, we dream big and are passionate about caring for our rich mix of people, customers, patients, and planet. That's why we are always looking for curious minds that see themselves imagining the unimaginable with us.

United As One for Patients, our purpose in Healthcare is to help create, improve and prolong lives. We develop medicines, intelligent devices and innovative technologies in therapeutic areas such as Oncology, Neurology and Fertility.

Our teams work together across 6 continents with passion and relentless curiosity in order to help patients at every stage of life.

Joining our Healthcare team is becoming part of a diverse, inclusive and flexible working culture, presenting great opportunities for personal development and career advancement across the globe.


UAE Insurance Reimbursement Associate
**Accountabilities and Responsibilities

Summary:

Key accountabilities with regard to:
Functional Responsibilities

  • Responsible for gaining and maintaining formulary access and reimbursement for our products.
  • Manage the entire reimbursement process for pharmaceutical products, including verifying insurance coverage, submitting claims, and resolving reimbursement issues.
  • Establish account plans, accounts archetypes including product opportunity plans.
  • Policy and

Procedure Development:
Develop and implement policies and procedures to optimize insurance reimbursement processes and ensure compliance with regulatory requirements.

  • Collaborate with crossfunctional teams, including market access, government affairs, sales, marketing, and customer service, to ensure awareness of access dynamics in market and address reimbursement challenges and optimize reimbursement strategies.
  • Insurance Verification: Verify patient insurance coverage and eligibility for pharmaceutical products, ensuring accurate billing and reimbursement.
  • Claims Processing: Oversee the timely submission of insurance claims and monitor claim status to ensure prompt reimbursement.
  • Denial Management: Investigate and resolve insurance claim denials, including appealing denied claims and communicating with insurance companies to address discrepancies.
  • Data Analysis: Analyze reimbursement trends and performance metrics to identify opportunities for process improvement and optimization.
  • Compliance: Stay informed about changes in insurance regulations and reimbursement policies, ensuring compliance with relevant guidelines and standards.
  • Training and Education: Provide training and education to internal teams and healthcare providers on insurance reimbursement processes and best practices.
  • Vendor Management: Collaborate with thirdparty vendors, such as billing companies and clearinghouses, to streamline reimbursement processes and resolve issues effectively.
**Qualifications: - Bachelor's degree in healthcare administration, business administration, or related field; advanced degree preferred.

  • Minimum of 35 years of experience in pharmaceutical reimbursement or healthcare insurance management.
  • Comprehensive knowledge of insurance reimbursement processes, including billing, coding, and claims adjudication.
  • Strong analytical skills with the ability to interpret data and identify trends.
  • Excellent communication and interpersonal skills, with the ability to collaborate effectively with internal and external stakeholders.
  • Detailoriented with strong organizational and problemsolving abilities.
  • Proficiency in healthcare billing software and Microsoft Office Suite.
  • Knowledge of regulatory requirements and compliance standards related to pharmaceutical reimbursement.
  • Ability to adapt to changing priorities and work effectively in a fastpaced environment.

What we offer:
We are curious minds that come from a broad range of backgrounds, perspectives, and life experiences.

We celebrate all dimensions of diversity and believe that it drives excellence and innovation, strengthening our ability to lead in science and technology.

We are committed to creating access and opportunities for all to develop and grow at your own pace. Join us in building a culture of inclusion and belonging that impacts millions and empowers everyone to work their magic and champion human progress