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Resubmission Associate Jobs In Dubai | Accumed

Accumed

Resubmission Associate Jobs In Dubai | Accumed

About the job

Role Summary:To audit & process all type of rejected claims received by the payers and resubmitting them correctly after thorough investigation and justification.Primary Responsibilities:

  • Properly process and audit all type of claims received by the payers, from the medical and insurance perspective.
  • Assure meeting the daily assigned target in terms of quantity & quality.
  • Report back any type of claims observation or issues that may affect the process.
  • Ensure that the medical ethics are respected at all times while performing the medical evaluation of the claims.
  • Participate in developing the rules engine and the billing system by providing new ideas or proposal in order to enhance the process.
  • Contribute in developing, updating and implementing the guidelines for evaluation and processing of medical claims, as well as policies and procedures and work instructions related to medical claims review and processing.
  • Gather relevant information to clearly describe and properly escalate issues to supervisors and managers.
  • Ensure high quality customer service and respect medical and work ethics at all times while conducting daily tasks.
  • Ensure that business decisions and processes are documented in a professional way and the communication requirements are being adhered to in a timely and professional manner.
  • Conduct training to improve the technical, insurance and medical skills and knowledge for team members as assigned by the supervisor or manager.
  • Provide all the needed support as advised by the supervisor based on the business need.
  • Other related tasks assigned by the line manager
Job Requirements:
  • Bachelors Degree in Medicine (MBBS) or any Bachelors degree in the medical field.
  • Any additional certifications related to the role will be an added advantage.
  • At least 2-3 years medical claims processing experience with a provider / payer/ TPA in the UAE is essential.
  • Should have at least 1year experience in handling resubmissions.
  • Good knowledge of insurance protocols.
  • Should have good IT skills.
  • Knowledge of ICDs, CPTs desirable
Key Performance Indicators (KPI’s).
  • Resubmit 80 to 100 claims per day
  • Maintain RD 15
  • Maintain 95% accuracy in coding. 0% critical errors.
  • To follow business rules / coding guidelines -100%.
  • Complete the targets as designated within the TAT.

To apply for this job please visit www.linkedin.com.

Basic Qualifications And Skills:

Sure! Here are some basic qualifications and skills often required for various roles. If you have a specific role in mind, please let me know, and I can tailor the list accordingly.

General Basic Qualifications:

  1. Educational Background:
    • High school diploma or equivalent
    • Relevant certifications or degrees (e.g., Bachelor’s degree for many professional roles)
  2. Experience:
    • Relevant work experience (varies by role)
    • Internships or volunteer work
  3. Technical Skills:
    • Basic computer literacy (e.g., Microsoft Office Suite)
    • Industry-specific software knowledge
  4. Communication Skills:
    • Strong verbal and written communication
    • Ability to interact effectively with colleagues and clients
  5. Problem-Solving Skills:
    • Analytical thinking
    • Creative approach to challenges
  6. Teamwork:
    • Ability to work well in a team environment
    • Collaboration and conflict resolution skills
  7. Time Management:
    • Ability to prioritize tasks
    • Meeting deadlines efficiently
  8. Adaptability:
    • Flexibility to adjust to changing environments
    • Willingness to learn new skills
  9. Customer Service:
    • Strong customer service orientation
    • Empathy and patience in dealing with clients
  10. Attention to Detail:
    • Accuracy in completing tasks
    • Thoroughness in work

Specific Skills for Various Roles:

IT and Tech Roles:

  • Programming languages (e.g., Python, Java, C++)
  • Understanding of network systems
  • Cybersecurity knowledge

Administrative Roles:

  • Proficiency in office software (e.g., Microsoft Office, Google Workspace)
  • Organizational skills
  • Administrative support experience

Marketing Roles:

  • Knowledge of digital marketing tools (e.g., SEO, SEM)
  • Social media management
  • Content creation and editing

Finance Roles:

  • Knowledge of financial software (e.g., QuickBooks)
  • Understanding of financial regulations and standards
  • Analytical skills for financial data

Healthcare Roles:

  • Relevant certifications (e.g., CPR, nursing license)
  • Knowledge of medical terminology
  • Patient care skills

If you provide more details about the specific role you’re interested in, I can offer a more targeted list of qualifications and skills.

Download CV: Click Here To Download Cv For Dubai & Across UAE Jobs

Benefits

Benefits offered by employers can vary widely depending on the company, industry, and location. However, here are some common benefits that many employers provide to their employees:

Health and Wellness:

  1. Health Insurance:
    • Medical, dental, and vision coverage
    • Prescription drug coverage
  2. Wellness Programs:
    • Gym memberships or discounts
    • Mental health support and counseling
    • Wellness incentives (e.g., rewards for meeting fitness goals)
  3. Health Savings Accounts (HSA) or Flexible Spending Accounts (FSA):
    • Pre-tax accounts for medical expenses

Financial and Retirement:

  1. Retirement Plans:
    • 401(k) or 403(b) plans with employer matching contributions
    • Pension plans
  2. Bonuses and Incentives:
    • Performance-based bonuses
    • Profit-sharing plans
    • Stock options or grants
  3. Financial Assistance:
    • Tuition reimbursement or education assistance
    • Student loan repayment programs
    • Financial planning services

Work-Life Balance:

  1. Paid Time Off (PTO):
    • Vacation days
    • Sick leave
    • Personal days
  2. Paid Holidays:
    • Standard holidays (e.g., New Year’s Day, Independence Day, Thanksgiving)
  3. Flexible Work Arrangements:
    • Remote work options
    • Flexible scheduling
    • Compressed workweeks

Family and Parenting:

  1. Parental Leave:
    • Maternity leave
    • Paternity leave
    • Adoption leave
  2. Childcare Support:
    • On-site childcare
    • Childcare subsidies or discounts
  3. Family Health Benefits:
    • Health insurance coverage for dependents
    • Dependent care flexible spending accounts

Professional Development:

  1. Training and Development Programs:
    • Access to online courses and workshops
    • Leadership training
    • Professional certification support
  2. Career Advancement Opportunities:
    • Mentorship programs
    • Internal job postings
    • Career path planning

Additional Perks:

  1. Commuter Benefits:
    • Subsidized transportation costs
    • Free parking
  2. Employee Discounts:
    • Discounts on company products or services
    • Partnerships with other companies for discounts
  3. Other Perks:
    • Company-sponsored events and outings
    • Free or subsidized meals and snacks
    • Wellness rooms or nap pods

These benefits help attract and retain talent, improve employee satisfaction and productivity, and contribute to overall well-being. The specific benefits package can significantly influence a job seeker’s decision to accept a job offer and an employee’s decision to stay with a company.

You Can Also Submit Your CV to the Following Jobs!

Beware Of Fraudsters!

Beware of Fraudsters: Tips to Protect Yourself

Fraudsters are constantly devising new ways to scam individuals and businesses. Here are some tips to protect yourself from becoming a victim of fraud:

1. Protect Your Personal Information:

  • Do not share personal details: Be cautious about sharing personal information such as your Social Security number, bank details, and passwords.
  • Secure your documents: Keep personal documents in a safe place. Shred any documents with sensitive information before discarding them.

2. Recognize Common Scams:

  • Phishing: Be wary of emails or messages that ask for personal information or direct you to a suspicious website.
  • Phone Scams: Do not provide personal information over the phone unless you are sure of the caller’s identity.
  • Lottery and Prize Scams: If it sounds too good to be true, it probably is. Be skeptical of claims that you have won a prize, especially if you did not enter a contest.
  • Impersonation Scams: Be cautious if someone claims to be from a government agency, bank, or other reputable organization and asks for personal information.

3. Secure Your Online Presence:

  • Use strong passwords: Create complex passwords and change them regularly. Avoid using the same password for multiple accounts.
  • Enable two-factor authentication: This adds an extra layer of security to your online accounts.
  • Be cautious online: Avoid clicking on links or downloading attachments from unknown sources.

4. Monitor Your Accounts:

  • Regularly check your bank statements: Look for any unauthorized transactions.
  • Review your credit report: Regularly check your credit report for any suspicious activity.

5. Stay Informed:

  • Educate yourself: Stay updated on the latest scams and fraud tactics.
  • Report suspicious activity: If you suspect you have been targeted by a scam, report it to the relevant authorities.

6. Use Security Software:

  • Install antivirus software: Ensure your devices are protected against malware and other threats.
  • Keep software up-to-date: Regularly update your operating system and software to protect against security vulnerabilities.

7. Be Cautious with Public Wi-Fi:

  • Avoid accessing sensitive information: Do not conduct financial transactions or access personal information over public Wi-Fi.
  • Use a VPN: A Virtual Private Network (VPN) can help secure your internet connection when using public Wi-Fi.

8. Verify Before Trusting:

  • Verify identities: Before providing information or making a transaction, verify the identity of the person or organization.
  • Check website security: Look for “https” in the website URL and a padlock icon, indicating the site is secure.

Additional Resources

By staying vigilant and informed, you can protect yourself from fraudsters and safeguard your personal and financial information.

You Can Also Submit Your CV to the Following Jobs!

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