Senior Officer - FWA

MedNet Global Healthcare Solutions LLC; Dubai; On-site; AED 120,000 - 160,000; Full time

Job summary

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.

Responsibilities

• 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.

Skills

Claims analysis

Provider audits

Data analytics

MS Excel

Audit experience UAE

Education

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

Tools

Data analytics tools

Audit software

Job description

Job Description - Senior Officer - FWA (2600000D)

Job Description

Senior Officer - FWA - ( 2600000D )

Description

As a member ofMunich RetheMedNet Global Health Care Solutions L.L.C.is one of the leading managed care service organizations that caters to healthcare needs. We are currently looking for a Senior Officer – FWA is responsible for the proactive management of claims analysis / audits to detect, investigate, address, and prevent Fraud, Waste, and Abuse (FWA). The role supports cost containment, quality assurance, and payment integrity initiatives through structured off-site and on-site audits of both open and closed claims files. The position ensures timely audit completion, accurate documentation, appropriate recovery actions, and comprehensive reporting in alignment with regulatory requirements and company policies.

Your Job:

- Lead medium to complex healthcare fraud, waste & abuse (FWA) investigations through claims analysis, provider audits, and medical record reviews.

- Analyze claims data and develop audit samples and analytical methodologies to identify suspicious trends, billing irregularities, and overutilization.

- Conduct onsite and offsite provider audits, including pre-authorization reviews, claims validation, and provider interviews.

- Ensure compliance with internal controls, contractual obligations, and regulatory requirements throughout the audit lifecycle.

- Prepare comprehensive audit, recovery, and regulatory reports, ensuring accuracy, quality, and timely submission.

- Monitor provider irregularities, utilization trends, and payment discrepancies, providing actionable insights and recommendations.

- Collaborate with cross-functional teams including Claims, Network, Medical, and Analytics to strengthen fraud prevention and risk mitigation efforts.

- Support team development by mentoring auditors, promoting knowledge sharing, and contributing to process improvement, automation, and fraud control initiatives.

Qualifications

Your profile:

Minimum Qualifications and Experience:

• - Bachelor’s or master’s degree in insurance, Medical, or Paramedical fields.
• - Audit and Coding certificates is an advantage.
• - 3–5 years’ experience within the UAE insurance market (TPA, Insurance Company, or Healthcare Provider).
• - Proven experience conducting on-site and off-site audits and handling FWA investigations in the UAE market.
• - Strong proficiency in MS Office, especially Excel.
• - Experience with data analytics tools.

Munich Re not only stands for fairness with regard to its clients; it is also an equal opportunity employer.

Primary Location

AE-AE-Dubai

Work Locations

MN GHS Dubai Internet City Dubai

Job

Customer/ Client Management

Organization

MedNet UAE (MN-UAE) BU

Schedule

Regular

Shift

Standard

Job Type

Full-time

Day Job

Job Posting

Sep 29, 2026, 1:10:03 PM

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