NMC Healthcare
Submission & Resubmission Team Lead
🇦🇪 Abu Dhabi, UAE🏢 On-site
Medical BillingClaims ManagementInsurance BillingAuditOSHInfection Control
At a Glance
- Category
- 🏥 Healthcare
- Level
- Senior
- Type
- Full-time
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- Review and Audit Medical Claims to ensure their accuracy.
- Resubmission of rejected claims.
- Ensure that the agreed price list and provider manual from insurance companies are followed for billing the service to the respective payers.
- Ensure that the Billing officers are updated on time with the rejections and corrective action is taken to avoid such instances in future.
- Handling the Resubmission of rejected claims, follow up with respective doctors for justifying the claims if necessary and prepare them for resubmission.
- Submit the claims with proper codes and format to insurance companies within the stipulated time.
- Performs any other jobs or duties assigned by the HOD from time to time within the scope of job title.
- Comply with all OSH and infection control policies, standards and procedures and cooperate with hospital management to comply those requirements.
- Work accordance with the documented OSH procedures and instructions, specific responsibilities.
- Be familiar with emergency and evacuation procedures.
- Notifying OSH Hazards, incidents, Near misses and issues and assistance with the preparation of risk assessments, incident reports.
- Comply with Waste management procedures and policies.
- Attend applicable OSH/Infection control training programs, mock drills and awareness programs.
- Use of appropriate personal protective equipment and safety systems.
Requirements
- •Experience in medical claims auditing and resubmission
- •Knowledge of insurance company price lists and provider manuals
- •Ability to coordinate with doctors for claim justification
- •Familiarity with OSH and infection control policies
- •Knowledge of waste management procedures
Responsibilities
- •Review and audit medical claims for accuracy
- •Handle resubmission of rejected claims
- •Ensure billing follows agreed price lists and provider manuals
- •Update Billing officers on rejections and corrective actions
- •Follow up with doctors for claim justifications
- •Submit claims with proper codes and formats within stipulated timelines
- •Comply with OSH and infection control standards
- •Notify OSH hazards, incidents, and near misses
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Guides for this role
Spot the Problem
- Find what's costing you interviews at NMC Healthcare
- Get every weak line rewritten
- Download a CV written for the Gulf
Free check in 60 seconds. Fixes $5.88 one-time, only if you want them.
GCC Info
Company
NMC Healthcare
5000+ employees
NMC Health is one of the largest private healthcare providers in the UAE. It operates hospitals, day surgery centers, and clinics across the country.