Submission & Resubmission Officer

NMC Healthcare
Sharjah
Workplace: OnsiteFull timeFunction: Finance & AccountingExperience: 2+ yearsEducation: bachelorsSkills: ["Confidentiality","Accuracy","Compliance","Communication","Root cause analysis"]

Submit and resubmit IP/OP medical claims for NMC Royal Hospital using ICD-10 CM and CPT/HCPCS coding standards. Ensure eligibility/authorization details are captured for first-time payment, upload e-claims to the DHPO/RIAYATI regulator portals, and meet daily RCM targets. Review denied claims, perform root-cause analysis, coordinate payer clarifications, and support denial trend reporting, reconciliation, audits, and coding compliance training.

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FursaFursa
NMC Healthcare
NMC Healthcare
1 day ago

Submission & Resubmission Officer

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Source: Company careers pageValidated by: Fursa AI
Last checked: 16 hours agoStatus: Live

Job Summary

Submit and resubmit IP/OP medical claims for NMC Royal Hospital using ICD-10 CM and CPT/HCPCS coding standards. Ensure eligibility/authorization details are captured for first-time payment, upload e-claims to the DHPO/RIAYATI regulator portals, and meet daily RCM targets. Review denied claims, perform root-cause analysis, coordinate payer clarifications, and support denial trend reporting, reconciliation, audits, and coding compliance training.
Location: Sharjah
Workplace: Onsite
Employment Type: Full time
Job Function: Finance & Accounting
Seniority: Mid level

Key Responsibilities

  • •Code and submit IP/OP claims with the highest specificity using ICD-10 CM and relevant CPT/HCPCS codes, ensuring eligibility and authorization verification for initial payment.
  • •Meet daily RCM targets for claim submission (250 OP/day or 18 IP/day) and upload e-claims to the DHPO or RIAYATI regulator portals.
  • •Review denied IP/OP claims, identify root causes, and resubmit with appropriate documentation and remarks based on complete EMR documentation.
  • •Track and report denial trends to management, coordinate payer clarification for denials and queries, and support claims reconciliation and payer audits with the RCM Manager.
  • •Support daily denial and submission reporting, provide coding/compliance training (ICD/CPT and medical coding requirements), and maintain coding data in hospital billing systems.

Key Requirements

  • •Minimum 2 years of experience in a similar role.
  • •Bachelor's degree in nursing, pharmacy, physiotherapy, or a related field (preferred).
  • •AAPC or AHIMA certification preferred/mandatory as per hospital policy.
  • •Ensure accurate medical coding and claims submission/resubmission aligned to payer policies.
  • •Ability to review denied claims, perform root-cause analysis, and document remarks for resubmissions.
Experience:2+ years
Education:Bachelor's
Skills:ConfidentialityAccuracyComplianceCommunicationRoot cause analysis
Certifications:AAPCAHIMA
Tech Stack:ICD-10 CMCPTHCPCSEMRDHPORIAYATI

Company Brief

NMC Healthcare
Operates a large network of hospitals, medical centers, and specialty clinics across the UAE and the wider Middle East. Provides general and specialized healthcare services, diagnostics, and outpatient care for individuals and families.
Industry: Hospitals & Clinics
Company Size: Enterprise (1,001+ employees)
Growth: Established Company
Headquarters: Abu Dhabi, United Arab Emirates
Founded: 1975
WebsiteLinkedIn