Medical Auditor

NMC; Abu Dhabi; On-site; AED 80,000 - 120,000; Full time

Job summary

NMC in Abu Dhabi is looking for a skilled professional to manage medical claims efficiently. This role involves reviewing and auditing claims, ensuring compliance with billing processes, and communicating with healthcare providers and insurance companies.

The ideal candidate will possess a Medical/Nursing degree, a proven track record in claims resubmission, and strong English communication skills. This role plays a crucial part in enhancing the billing cycle and minimizing financial discrepancies.

Qualifications

• Graduate from a recognized medical or nursing university.
• Experience in insurance claims resubmission.
• Experience in medical coding is a plus.

Responsibilities

• Review and audit medical claims for accuracy.
• Resubmit rejected claims and handle follow-ups.
• Ensure billing compliance with insurance company guidelines.

Skills

Attention to detail

Oral and written English proficiency

Education

Medical/Nursing degree

Job description

Responsibilities

• Review and audit medical claims to ensure accuracy.
• Resubmit 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 billing officers are updated on time with rejections and corrective action is taken to avoid such instances in the future.
• Handle 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.

Qualifications

• Medical/Nursing graduate from a recognized university.
• Experience in insurance claims resubmission.
• Experience in medical coding is preferable.
• Excellent command of oral and written English.