NMC -
الإمارات , ابو ظبي
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NMC

تفاصيل الوظيفة

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.



Qualifications:
  • 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.


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الإمارات, ابو ظبي