| Job Location | United Arab Emirates |
| Education | Medical Professionals |
| Salary | Not Mentioned |
| Industry | Insurance / Claims |
| Functional Area | Not Mentioned |
Location: UAEKey Responsibilities:– Conduct audits of healthcare providers’ claims to ensure accuracy and compliance.– Review claims for medical necessity, correct coding, and adherence to insurance and regulatory standards.– Analyze data to identify trends such as overutilization, overbilling, or policy non-compliance.– Collaborate with the claims department and other internal teams to support the implementation of corrective actions.– Maintain detailed audit documentation and generate reports for both management review and regulatory submissions.– Stay current with UAE healthcare regulations, including DHA, DOH, MOH guidelines, and payer-specific policies.Desired Candidate’s Profile:– 3-5 years of experience in medical claims auditing within the UAE healthcare/insurance sector.– MBBS/BDS is mandatory. Additional qualifications or certifications such as CPC/CPMA are an added advantage.– Familiarity with UAE health authority guidelines (DHA, DOH, MOH).– Strong claims auditing and claims adjudication skills.– Excellent communication skills– Ability to work independently and as part of a team
Keyskills :
Experience in medical claims auditing
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