Medical Auditor

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Medical Auditor at NMC Healthcare in Abu Dhabi is a full-time onsite role focused on reviewing and auditing medical claims for accuracy, coordinating the resubmission of rejected claims, and ensuring billing follows the agreed price lists and insurance provider manuals. The ideal candidate will have a medical or nursing degree, experience with insurance claim resubmission, preferably with medical coding knowledge, and strong English communication. To apply, tailor your resume to demonstrate precise claims auditing, rapid corrective action on rejections, and collaboration with doctors and billing officers; highlight familiarity with payer guidelines, timely submission habits, and clear documentation of codes and formats. Show measurable results such as reduced rejections and faster turnarounds.

3.1 Review and Audit Medical Claims to ensure their accuracy.

3.2 Resubmission of rejected claims

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

3.5 Ensure that the Billing officers are updated on time with the rejections and corrective action is taken to avoid such instances in future 

3.6 Handling the Resubmission of rejected claims, follow up with respective doctors for justifying the claims if necessary and prepare them for resubmission.

3.7 Submit the claims with proper codes and format to insurance companies within the stipulated time.

• 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.

• Medical/Nursing graduate from a recognized university. 
• Experience in Insurance Claims Resubmission
• Experience in Medical Coding is preferable.
• Excellent command of oral and written English.