Medical Auditor
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About the Role
NMC Health plc seeks a Medical Auditor to review and audit medical claims, handle resubmission of rejected claims, ensure correct billing codes and formats, and coordinate with doctors for claim justification.
Key Skills for This Role
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Overview
- 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.
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