Submission & Resubmission Team Lead

NMC Healthcare
Abu Dhabi
Workplace: OnsiteFull timeFunction: Administration & Executive AssistanceExperience: 2+ yearsEducation: bachelorsSkills: ["Leadership","Attention to detail","Communication","Risk awareness","Compliance"]

Lead the medical claims submission and resubmission process by auditing claims for accuracy, ensuring coding and required formats meet payer and regulatory rules, and managing rejected/resubmission workflows. Coordinate with doctors to obtain claim justifications, follow agreed price lists and provider manuals, and partner with Billing Officers to implement corrective actions. Manage a team of medical auditors while maintaining compliance with OSH and infection control procedures, including training and incident reporting.

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FursaFursa
NMC Healthcare
NMC Healthcare
1 day ago

Submission & Resubmission Team Lead

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Source: Company careers pageValidated by: Fursa AI
Last checked: 22 hours agoStatus: Live

Job Summary

Lead the medical claims submission and resubmission process by auditing claims for accuracy, ensuring coding and required formats meet payer and regulatory rules, and managing rejected/resubmission workflows. Coordinate with doctors to obtain claim justifications, follow agreed price lists and provider manuals, and partner with Billing Officers to implement corrective actions. Manage a team of medical auditors while maintaining compliance with OSH and infection control procedures, including training and incident reporting.
Location: Abu Dhabi
Workplace: Onsite
Employment Type: Full time
Job Function: Administration & Executive Assistance
Seniority: Manager level

Key Responsibilities

  • •Review and audit medical claims to ensure accuracy before submission.
  • •Resubmit rejected claims and follow up on pending cases within stipulated timelines.
  • •Ensure agreed price lists and provider manuals are followed for billing services to respective payers.
  • •Coordinate with doctors to obtain claim justifications and prepare rejected claims for resubmission.
  • •Manage the team of medical auditors and apply medical knowledge and best insurance practice during claim review and adjudication.

Key Requirements

  • •Graduate in Medical/Paramedical field (Nursing, Pharmacy, etc.) from a recognized university.
  • •Minimum 2 years of experience in Insurance Claims Management/Adjudication.
  • •Experience in Medical Coding is preferred.
  • •Excellent command of spoken and written English.
Experience:2+ yearsHealthcareInsurance claimsMedical coding
Education:Bachelor's in Medical/Paramedical (Nursing, Pharmacy, etc.)
Skills:LeadershipAttention to detailCommunicationRisk awarenessCompliance
Languages:English

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