Medical Auditor

🏢 NMC
📍 Abu Dhabi, United Arab EmiratesFull-timeOn-site
📅 Posted: 2mo ago🔄 Updated: 2mo ago
CV%
✨ AI Summary
The Medical Auditor will be responsible for reviewing and auditing medical claims to ensure accuracy and resubmitting rejected claims. This role involves ensuring adherence to agreed price lists and provider manuals from insurance companies for billing services. The Medical Auditor will also be responsible for updating billing officers on rejections and implementing corrective actions to prevent future occurrences. Additionally, the role requires following up with doctors for claim justifications and preparing claims with proper codes and formats for timely submission to insurance companies.
Required Skills
Other
Englishmedical codingclaims adjudication
Requirements
Must have a Medical/Nursing graduate degree from a recognized university and experience in Insurance Claims Resubmission. Experience in Medical Coding is preferable. Must have excellent command of oral 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