Medical Claims Auditor
3 weeks ago
Experienced in Medical Claims Auditor in the insurance or TPA.
- Coordinate with the providers or payers in case of mismatch between the provided statement of account and actual invoice submission. External Audit: Auditing the providers (Medical Documentation and Billing)
- Updating the external audit report to the management
- Auditing the In-patient, Out-patient reimbursement claims
- Maintaining the Internal audit reports of claim processing
- Handling / responding the queries of Claims Team on Medical Coding (DRG, unbundling code, up coding, medically justify)
- Interacting with other Teams (Claim Centre, Network Team and IT) on Medical coding
- Visit providers to check further records, detect fraud cases and report to the concerned departments for action
- Temporarily due to COVID-19
**Job Types**: Full-time, Permanent
Pay: AED7,000.00 - AED9,000.00 per month
Ability to commute/relocate:
- Abu Dhabi: Reliably commute or planning to relocate before starting work (required)
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