Medical Auditor, NMC Royal Hospital, Khalifa City, Abu Dhabi UAE

• 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.

Eligibility Criteria?

Qualification

• Medical / paramedical (Nursing, pharmacy, etc.) graduate from a recognized university.

Experience

• Minimum 2 years of experience in Insurance Claims management / adjudication.
• Experience in Medical Coding is preferable.

Skills Desired