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Assistant Manager - Provider Claims Auditing

Abu Dhabi Abu Dhabi >
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Insurance Insurance >
Details
https://dbzstatic-a.akamaihd.net/.dist_28d05d0dde574b78dad37a9347aa96b13ec9e58c/ 8259

Details: Posted on: 25th January 2018

  • Employment Type: Full Time
  • Monthly Salary: 12,000 - 19,999 AED
  • Benefits: Annual ticket, life and medical insurance
  • Minimum Work Experience: 2-5 Years
  • Minimum Education Level: Bachelors Degree
  • Listed By: Employer
  • Company Size: 201-500 Employees
  • Career Level: Senior

Description:


Required for a well known TPA based in Abu Dhabi.

Job description:

-UAE experience in HAAD and DHA CPT Coding.
-Supervise DRG claims, follow-up and communicate with HAAD /DHA and DRG updates as well as to sort out DRG issues.
-Check on daily basis new updates in HAAD /DHA website and inform higher management on updates.
-Conducting hospital routine audits and report findings.
-Conduct and report on weekly basis internal audit on claim production. Audit will include claims for inpatient and outpatient services submitted as Eclaims.
-Conduct training sessions for claims processing department on coding and processing guidelines.
-Respond specific queries on coding and guidelines raised by other departments involved.
-Respond to queries and assist in coding of inpatient and outpatient claims.
-Communicate with HAAD /DHA to obtain full clarification and interpretation of the applicable rules and regulations required for the claims processing department.

Qualifications:

2-5 year's experience in UAE healthcare / insurance industry
Certificate in coding (CPC,AAPC,AHIMA,LOMA)
Excellent knowledge in DRG as per HAAD / DHA.
Excellent oral and written communication skills.
Advanced MS Excel experience / Software.
Team player and can handle confidential information.
Can handle a team with good aptitude and responsibility.


Email on: vacancytpa @gmail.com



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