Submission & Resubmission Officer NMC healthcare LLC

Posted on 11 Mar

Experience

2 - 6 Years

Education

MBA/PG Diploma in Business Mgmt

Nationality

Any Nationality

Gender

Any

Vacancy

1 Vacancy

Job Description

Roles & Responsibilities

  • 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.

OSH ROLES & RESPONSIBILITIES

GENERAL

  • Comply with reasonable OSH instructions, policies and safe working procedures.

  • Use of appropriate personal protective equipment and safety systems.

  • Be familiar with emergency and evacuation procedures.

  • Not willfully or recklessly endanger anyone’s health and safety.

  • Assist with the preparation of risk assessments.

  • Report OSH Hazards, incidents, Near misses and issues.

  • Reduce, Reuse, Recycling of waste as much as possible.

  • Attend all OSH Trainings, awareness programs and mock drills.

  • Participates in the OSHMS audits, inspections, ensuring standards are maintained.

Additional duties/responsibilities (related to ADHICS) assigned to this position:

Health Information Literacy and Skills

  • Adhere to information systems policies and procedures as required by Health Care Organization.

Privacy, Confidentiality of Health Information

  • Follow security and privacy policies and procedures to the use of networks, including intranet and Internet.

  • Follow confidentiality and security measures to protect electronic health information.

  • Maintain data integrity and validity within an information system.

  • Report any possible breaches of confidentiality in accordance with organizational policies.

Health Information/Data Technical Security

  • Apply departmental and organizational data and information system security policies.

Basic Computer Literacy Skills

  • Use basic word processing, spreadsheet and desktop presentation applications as applicable to your work.

  • Demonstrate proficiency in Windows operating environment.

  • Demonstrate use of email, addressing, forwarding, attachments, netiquette.

BCP ROLES & RESPONSIBILITIES

  • Achieving an adequate level of general awareness regarding business continuity.

  • Being aware of the contents of their service areas disaster recovery plan and any specific role or responsibilities allocated.

  • Participating actively in the business continuity programme when required.

  • Ensuring information governance standards continue to be applied to data and information during an incident.

Desired Candidate Profile

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

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

  • Preferred Skill: Experience in Medical Coding is preferable.

  • Language: 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.

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