Medical Claims Resubmission Specialist

AimGulf; Abu Dhabi; On-site; AED 60,000 - 90,000; Full time

Job summary

NMC Healthcare in Abu Dhabi is seeking a Submission & Resubmission Officer responsible for reviewing and auditing medical claims, and handling the resubmission of rejected claims in line with payer guidelines.

You will coordinate with doctors to obtain justifications for rejected claims, update billing officers on rejections, and ensure timely submission of claims to insurers with the correct codes.

Qualifications

• Experience in insurance claims resubmission.
• Experience in medical coding is preferred.

Responsibilities

• Review and audit medical claims to ensure accuracy and compliance.
• Handle the resubmission of rejected claims.
• Ensure that agreed price lists and provider manuals from insurance companies are followed when billing services to respective payers.
• Ensure billing officers are updated promptly on claim rejections and corrective actions are taken to prevent recurrence.
• Follow up with the respective doctors to obtain justifications for rejected claims, where necessary, and prepare claims for resubmission.
• Submit claims to insurance companies with the correct codes and format within the stipulated timelines.

Skills

English proficiency

Education

Medical/Nursing degree

Job description

NMC Healthcare in Abu Dhabi is seeking a Submission & Resubmission Officer responsible for reviewing and auditing medical claims, and handling the resubmission of rejected claims in line with payer guidelines.

You will coordinate with doctors to obtain justifications for rejected claims, update billing officers on rejections, and ensure timely submission of claims to insurers with the correct codes.