Submission & Resubmission Officer

🏢 NMC
📍 Abu Dhabi, United Arab EmiratesFull-timeHybrid
📅 Posted: 3w ago🔄 Updated: 3w ago
CV%
✨ AI Summary
The Submission & Resubmission Officer will be responsible for the accurate and timely submission and resubmission of claims and documentation. Key duties include reviewing rejected claims, verifying documentation, monitoring claim status, investigating denial reasons, and maintaining accurate records. The role also involves ensuring compliance with payer guidelines and preparing performance reports. This position requires a Bachelor's degree or diploma in a related field and 1-3 years of experience in medical claims submission or revenue cycle management.
Required Skills
Other
○claims submission○claim resubmission○claim verification○payer guidelines○coding guidelines
Information Technology
○Technical Documentation○Monitoring○Incident Management○Quality Assurance
Soft Skills & Professional Competencies
○Problem Solving
Engineering, Construction & Trades
○Reliability-Centered Maintenance
Finance, Legal & Governance
○Tax Compliance
Business, Sales & Management
○Progress Reporting
Nice to have:
Other
○insurance claim processing
Requirements
Candidates must possess a Bachelor's degree or diploma in Healthcare Administration, Medical Records, or Business Administration. A minimum of 1-3 years of experience in medical claims submission, revenue cycle management, or healthcare operations is required. Familiarity with insurance claim processing and payer requirements is preferred.
Description
  • Submit claims and required documentation accurately and within established timelines.
  • Review rejected or denied claims and prepare resubmissions after correcting identified issues.
  • Verify claim completeness, coding, and supporting documentation before submission.
  • Monitor claim status and follow up on pending, rejected, or returned claims.
  • Investigate rejection and denial reasons and coordinate with relevant departments to resolve issues.
  • Maintain accurate records of submissions, resubmissions, and claim outcomes.
  • Ensure compliance with payer guidelines, company policies, and regulatory requirements.
  • Communicate with insurance companies, third-party administrators (TPAs), and internal stakeholders regarding claim status and requirements.
  • Prepare daily, weekly, and monthly reports on submission activities, rejection trends, and resubmission performance.
  • Escalate complex or recurring issues to the Team Lead or Manager.
  • Participate in quality improvement initiatives to reduce rejection rates and improve first-pass claim acceptance.
  • Stay updated on changes in payer requirements, coding guidelines, and submission processes.
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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