Senior FWA Investigator - Claims Audits & Fraud Prevention

MedNet Global Healthcare Solutions LLC; Dubai; Sur place; AED 120 000 - 160 000; Plein temps

Résumé du poste

Munich Re, via its MedNet UAE (MN-UAE) BU, seeks a Senior Officer – FWA to lead investigations, audits, and data-driven analyses to detect fraud, waste, and abuse in UAE healthcare claims.

You will conduct onsite and offsite audits, develop sampling methodologies, mentor junior auditors, and report findings to ensure compliance, payment integrity, and cost containment in line with regulatory requirements.

Qualifications

• Bachelor’s or master’s degree in insurance, medical, or paramedical fields.
• 3–5 years’ experience in UAE insurance market with FWA audits.
• Proficiency in MS Excel and data analytics tools.

Responsabilités

• Lead medium to complex FWA investigations through claims analysis and provider audits.
• Conduct onsite and offsite audits, including pre-authorization reviews and interviews.
• Develop audit samples and methodologies to identify trends and overutilization.
• Prepare audit and regulatory reports with timely submission.
• Collaborate with Claims, Network, Medical, and Analytics teams.

Connaissances

Claims analysis

Provider audits

Data analytics

MS Excel

Audit experience UAE

Formation

Bachelor’s or Master’s degree in insurance, medical, or paramedical fields

Outils

Data analytics tools

Audit software

Description du poste

Munich Re, via its MedNet UAE (MN-UAE) BU, seeks a Senior Officer – FWA to lead investigations, audits, and data-driven analyses to detect fraud, waste, and abuse in UAE healthcare claims.

You will conduct onsite and offsite audits, develop sampling methodologies, mentor junior auditors, and report findings to ensure compliance, payment integrity, and cost containment in line with regulatory requirements.