Submission & Resubmission Officer
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Key skills for this role
About the Role
NMC Healthcare is seeking a Submission & Resubmission Officer to review and audit medical claims, resubmit rejected claims, and ensure billing compliance. The role involves coordinating with physicians and insurance companies to resolve claim issues.
Key Skills for This Role
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Overview
- Review and audit medical claims to ensure accuracy and compliance
- Resubmit rejected claims after necessary corrections and validation
- Ensure billing is done in accordance with agreed price lists and insurance provider manuals
- Keep billing officers informed of claim rejections and ensure corrective actions are implemented to prevent recurrence
- Coordinate with treating physicians to obtain justification for rejected claims and prepare them for resubmission
- Submit claims with accurate coding and correct format to insurance companies within stipulated timelines
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