Dentist Quality & Audit Lead — Claims & Compliance

QLM; Doha; On-site; QAR 167,000 - 279,000; Full time

Job summary

QLM in Doha, DAW, QA, is hiring a Medical Quality & Audit Officer (Dentist) for a full-time, on-site role. You will conduct provider field audits, review claims, and ensure policy compliance across Qatar.

The candidate should hold a Dentistry degree with 3–5 years in health insurance or medical audit, possess strong ICD-10/CPT/DRG coding knowledge, and be able to guide junior teammates while traveling as needed.

Qualifications

• Bachelor's degree in Dentistry is required.
• 3–5 years in health insurance, medical audit or claims management.
• Strong knowledge of ICD-10, CPT, and DRG coding.
• Experience in provider audits and medical claims review.
• Excellent analytical, investigative, and report-writing skills.
• Proficient in Microsoft Office and EMR systems.
• Willing to travel within Qatar for provider field audits.

Responsibilities

• Conduct provider field audits and clinical documentation reviews.
• Review medical claims and pre-approvals for coding accuracy, medical necessity, and policy compliance.
• Identify billing irregularities, fraud, waste, and abuse indicators.
• Prepare audit reports, document findings, and communicate with healthcare providers.
• Manage audit cases from initiation through completion.
• Support recovery, reconciliation, and quality improvement initiatives.
• Guide and support Senior Associates during audit activities.
• Ensure compliance with internal policies, audit standards, and regulatory requirements.

Skills

Analytical skills

Investigative skills

Report writing

Travel willingness

ICD-10/CPT/DRG

Claims review

Dentistry background

Education

Bachelor's degree in Dentistry

Tools

Microsoft Office

EMR systems

Job description

QLM in Doha, DAW, QA, is hiring a Medical Quality & Audit Officer (Dentist) for a full-time, on-site role. You will conduct provider field audits, review claims, and ensure policy compliance across Qatar.

The candidate should hold a Dentistry degree with 3–5 years in health insurance or medical audit, possess strong ICD-10/CPT/DRG coding knowledge, and be able to guide junior teammates while traveling as needed.