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Medical Auditor/ منذ 3 أسابيع

Job Description

DUTIES AND RESPONSIBILITIES :

  • Review and Audit Medical Claims to ensure their accuracy.
  • Resubmission of rejected claims 
  • Ensure that the agreed price list and provider manual from insurance companies are    followed for billing the service to the respective payers.
  • Ensure that the Billing officers are updated on time with the rejections and corrective action is taken to avoid such instances in future 
  • Handling the Resubmission of rejected claims, follow up with respective doctors for justifying the claims if necessary and prepare them for resubmission. 
  • Submit the claims with proper codes and format to insurance companies within the stipulated time. 
  • Performs any other jobs or duties assigned by the HOD from time to time within the scope of job title.

Responsibilities

DUTIES AND RESPONSIBILITIES :

  • Review and Audit Medical Claims to ensure their accuracy.
  • Resubmission of rejected claims 
  • Ensure that the agreed price list and provider manual from insurance companies are    followed for billing the service to the respective payers.
  • Ensure that the Billing officers are updated on time with the rejections and corrective action is taken to avoid such instances in future 
  • Handling the Resubmission of rejected claims, follow up with respective doctors for justifying the claims if necessary and prepare them for resubmission. 
  • Submit the claims with proper codes and format to insurance companies within the stipulated time.
  • Performs any other jobs or duties assigned by the HOD from time to time within the scope of job title.

Qualifications

QUALIFICATION, LICENSURE, EDUCATION, EXPERIENCE, SPECIAL SKILLS :

  • Medical/paramedical (Nursing, pharmacy, etc.) graduate from a recognized university. 
  • Experience in Insurance Claims management/adjudication (minimum 2 years) 
  • Experience in Medical Coding is preferable. 
  • Excellent command of oral and written English. 
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مشاركة

NMC Healthcare

NMC Healthcare

  • سنة التأسيس
    1974
  • الموقع الإلكتروني
    https://nmc.ae/
  • عنوان
    Abu Dhabi
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