Joy David
Dubai
Summary
Accomplished professional with expertise in facility empanelment and onboarding, contract management, and CPT/DRG code set implementation. Demonstrates proficiency in payer coordination, internal billing systems, and master tariff maintenance, ensuring seamless system updates and price audits. Adept at managing contract compliance and fostering strong payer relationships through effective complaint resolution and market analysis. Skilled in new service pricing and payer tariff inclusions, with a focus on cross-functional RCM collaboration and oversight. Committed to protocol implementation to enhance operational efficiency and drive strategic growth within the healthcare sector.
Overview
20
20
years of professional experience
Work history
Asst. Manger - Network & Contract Management
Kings College Hospital London Dubai Group
Dubai
03.2019 - 05.2025
- Handled empanelment of new facilities including documentation, negotiation, finalization, and all necessary system updates.
- Worked on Mapping, pricing, and Implementation of new Code sets (CPT 2018 & CPT 2021) along with DRG.
- Communicated with payers till finalization and update internal records and systems once it is agreed and finalized.
- Managed internal billing system, including service creation, payer and corporate tariff mapping, and timely updates in accordance with policy changes.
- Conducted regular price audits in Internal billing system to avoid errors and to ensure alignment with contractual agreements.
- Managed end-to-end contract lifecycle including initiation, negotiation, execution, monitoring, renewal/termination, and compliance.
- Reviewed and finalized Payer and Corporate contracts; maintained accurate records of contracts and addendums.
- Built and maintained strong payer relationships; handled communication, complaints resolution etc.
- Maintained Master Tariff for Cash, Payer, and corporate pricing both in Excel and internal HIS system.
- Priced new services based on cost analysis, competitor benchmarking, and market standards.
- Managed new service additions with payers from proposal preparation, negotiation to finalization and system updates.
- Collaborated with other RCM functions such as Pre-Auth and Denial Analysis teams to support and implement changes in process and protocols in system.
- Oversaw Revenue Cycle Management (RCM) processes and implemented payer protocols, ensuring effective communication of key updates to internal teams.
Asst. Insurance Manager
Emirates Hospitals Group
08.2016 - 02.2019
- Led pricing and tariff negotiations with insurers, aligning with market standards and regulatory factors (HAAD/DHA).
- Managed Cost Per Claim (CPC) model through clinician-level analysis and policy training.
- Coordinated insurance audits and ensured timely review of audit reports.
- Handled surgeon fee finalization and insurance issue resolution with CBD doctors.
- Ensured compliance with DHA protocols; attended authority meetings and implemented updates.
- Trained doctors on insurance protocols, eRx/eClaim systems, and clinical documentation.
- Analysed monthly claim rejections and implemented preventive measures to reduce denials.
- Supervised pre-approval processes to improve turnaround time and reduce patient wait times.
- Delivered cross-departmental training on insurance rules and internal policies.
- Resolved insurance-related patient complaints with focus on service quality.
- Directed team activities and delegated tasks to enhance operational efficiency.
Insurance Supervisor
Emirates Hospital Group
07.2008 - 07.2016
- Managed IP/OP approval process for in-house and CBD doctors in coordination with clinics.
- Reported weekly approval status to Insurance Manager.
- Trained new doctors and nurses on insurance protocols, eRx/eClaim systems, and approval procedures.
- Handled patient insurance-related complaints and queries.
- Provided treatment cost estimates to insurers and corporate clients for surgical/IP cases.
- Coordinated with insurers on pricing and inclusion of new services/procedures.
Cashier & Insurance Coordinator
Al Zahra Hospital Group
03.2005 - 05.2008
- Eligibility verification, cost estimate preparation and undertake In-patient and Out-patient approvals required for Insured patients.
- Advise patients / front desk staffs on Card eligibility and Insurance Coverage details.
- Handling queries if any from other Hospital staff relating to Insurance coverage of different insurance companies with whom Al Zahra has arrangements.
Education
Certified Professional Coder- CPC -
AAPC
Dubai /2016 - /2016
Bachelor - Commerce
Kannur University
India /1997 - /2000
Skills
Facility Empanelment & Onboarding
Contract Management- Review, Documentation, and lifecycle
CPT/DRG Code Set Implementation & Payer Coordination
Internal Billing System & Payer Tariff handling
Master Tariff Maintenance & System Updates
Price Audits & Contract Compliance
Payer Relationship Management & Complaint resolution
Market Analysis and New Service pricing & Payer Tariff Inclusions
RCM Oversight & Protocol Implementation
Languages
English
Hindi
Malayalam
Reference
References available upon request.
Personal Information
- Date of birth: 03/16/80
- Nationality: Indian
- Marital status: Married
- Visa status: Employment
Timeline
Asst. Manger - Network & Contract Management
Kings College Hospital London Dubai Group
03.2019 - 05.2025
Asst. Insurance Manager
Emirates Hospitals Group
08.2016 - 02.2019
Insurance Supervisor
Emirates Hospital Group
07.2008 - 07.2016
Cashier & Insurance Coordinator
Al Zahra Hospital Group
03.2005 - 05.2008
Certified Professional Coder- CPC -
AAPC
/2016 - /2016
Bachelor - Commerce
Kannur University
/1997 - /2000
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