Submission & Resubmission Officer

🏢 NMC
📍 Abu Dhabi, United Arab EmiratesFull-timeOn-site
📅 Posted: 3mo ago🔄 Updated: 3mo ago
CV%
✨ AI Summary
The Submission & Resubmission Officer will be responsible for reviewing and auditing medical claims to ensure accuracy and completeness. This role involves managing the resubmission of rejected claims in line with payer requirements, ensuring adherence to agreed price lists and insurance provider manuals for accurate billing. The officer will also update billing officers on claim rejections, implement corrective actions, and coordinate resubmission of rejected claims, including follow-up with physicians for justification where required. The position requires submitting claims with accurate coding and proper formatting to insurance companies within stipulated timelines.
Required Skills
Other
Englishmedical claims resubmissionmedical coding
Finance, Legal & Governance
Auditing
Requirements
Medical or Nursing graduate from a recognized university. Experience in insurance claims resubmission. Medical coding experience is preferred. Excellent command of spoken and written English.
Description

3.1 Review and Audit Medical Claims to ensure their accuracy.

 

3.2 Resubmission of rejected claims.

 

3.4 Ensure that the agreed price list and provider manual from insurance companies are followed for billing the service to the respective payers.

 

3.5 Ensure that the Billing officers are updated on time with the rejections and corrective action is taken to avoid such instances in future.

 

3.6 Handling the Resubmission of rejected claims, follow up with respective doctors for justifying the claims if necessary and prepare them for resubmission.

 

 

             3.7 Submit the claims with proper codes and format to insurance companies within the stipulated time.

 

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🎯 Overalli74%
⚡ Skillsi85%
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Ontology Match: 85.0
Matched:✓ Requirements Matching✓ Ontology Skills Mapping
📜 Eligibilityi49%
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Local: 19600%
🏗️ Career Fiti91%
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Seniority: 91.0
📋 Requirementsi67%
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Domain: 67.0
🔥 Motivationi78%
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Title Fit: 78.00