Submission & Resubmission Officer NMC healthcare LLC

Posted 46 min ago

Experience

2 - 6 Years

Education

MBA/PG Diploma in Business Mgmt

Nationality

Any Nationality

Gender

Any

Vacancy

1 Vacancy

Job Description

Roles & Responsibilities

The Resubmission Officer will be responsible for filing and tracking insurance claims, process insurance and disability claims in a timely manner.

Responsibilities

  • Process the resubmission of rejected claims on the system, follow up with respective doctors for justification if necessary, and prepare them for resubmission.

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

  • Ensure that all concerned teams, such as FO, coders, and doctors, are updated on time with the rejections and corrective action is taken to avoid such instances in the future.

  • 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.

OSH & Compliance Responsibilities:

  • Comply with all OSH and infection control policies, standards, and procedures and cooperate with hospital management to comply with those requirements.

  • Work in accordance with the documented OSH procedures and instructions, specific responsibilities.

  • Be familiar with emergency and evacuation procedures.

  • Notify OSH hazards, incidents, near misses, and issues, and assist with the preparation of risk assessments and incident reports.

  • Comply with waste management procedures and policies.

  • Attend applicable OSH/Infection control training programs, mock drills, and awareness programs.

  • Use appropriate personal protective equipment and safety systems.

  • Ensure that employees follow applicable OSH/Infection control policies, procedures, and standards.

  • Provide OSH information, training, and supervision to staff.

  • Report any OSH-relevant incidents, near misses, and hazards in the departments in a timely manner.

  • Make sure that incident corrective actions have been implemented.

  • Assist with preparation of risk assessments and monitoring the control measures.

  • Ensure training is conducted, including general/departmental/FMS/OSH orientation for new employees and transferred employees, as well as refresher training for department staff.

Desired Candidate Profile

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

  • Experience in Insurance Claims management/adjudication (minimum 2 years).

  • Experience in Medical Coding is preferable.

  • Excellent command of oral and written English.

Employment Type

    Full Time

Company Industry

Department / Functional Area

Keywords

  • ECTD
  • FDA
  • Regulatory Affairs Associate
  • Compliance
  • Submission Coordinator
  • Regulatory Submissions
  • ICH
  • Regulatory Documentation Specialist

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NMC healthcare LLC

NMC is a diversified business conglomerate. One of the focus areas being Healthcare, with Specialty Hospitals, Medical centres and Clinics across the UAE.