Senior Healthcare Coding & Fraud Analytics Specialist

Remotedxb; Dubai; On-site; AED 300,000 - 600,000; Full time

Benefits offered by this job

Medical benefits

401(k) plan

Paid time off

Disability & life insurance

Job summary

GDIT in Dubai is seeking a Senior Healthcare Claims Analyst to perform analytical tasks to identify fraud, waste, and abuse referrals and leads, collaborate on HFPP analytic reports, and review medical claims for accuracy and coding compliance.

You will conduct research on insurance policies and reimbursement criteria, participate in QA initiatives to meet regulatory requirements, and respond to analytic output questions from internal and external parties. CPC/CCS preferred.

Qualifications

• Bachelors degree or equivalent work experience.
• 8+ years of experience in healthcare claims analysis.
• CPC or CCS certification.
• Expertise in medical terminology and healthcare coding (ICD-10, CPT, HCPCS).
• Experience in program integrity and healthcare fraud, waste, and abuse activities.
• Extensive knowledge of insurance regulations and reimbursement methodologies.
• Expert level knowledge of Microsoft Office suite.
• Experience with Tableau, Amazon WorkSpaces, Jira, and Confluence.

Responsibilities

• Perform analytical tasks to identify fraud, waste, and abuse referrals and leads.
• Collaborate on the development of HFPP analytic reports.
• Review and analyze medical claims for accuracy, completeness, and compliance with coding guidelines.
• Conduct research and investigation of insurance policies and reimbursement criteria.
• Participate in quality assurance initiatives to ensure adherence to regulatory requirements.
• Evaluate and respond to analytic output questions from internal and external parties.

Skills

Healthcare claims analysis

Medical terminology

Regulatory compliance

Fraud awareness

Education

Bachelor's degree or equivalent

Tools

Tableau

Amazon WorkSpaces

Jira

Confluence

Microsoft Office

Job description

GDIT in Dubai is seeking a Senior Healthcare Claims Analyst to perform analytical tasks to identify fraud, waste, and abuse referrals and leads, collaborate on HFPP analytic reports, and review medical claims for accuracy and coding compliance.

You will conduct research on insurance policies and reimbursement criteria, participate in QA initiatives to meet regulatory requirements, and respond to analytic output questions from internal and external parties. CPC/CCS preferred.