Senior Officer RCM

To ensure the accuracy compliance and efficiency of outpatient claims processing by conducting detailed audits analyzing denials and identifying resubmission opportunities The role requires expertise in coding standards regulatory rules DOH DHA MOH and best practices for claim management in the UAE healthcare system Responsibilities Claims Auditing and Analysis Audit outpatient claims to ensure accuracy in coding billing and documentation Review denied claims to identify root causes and trends e g coding errors eligibility medical necessity Perform audits on processed claims to confirm compliance with DOH DHA and MOH guidelines Ensure proper application of CPT ICD10CM HCPCS and other coding standards Denial Analysis and Management Analyse denial trends and patterns to identify areas for improvement Collaborate with the coding and resubmission teams to address common denial reasons Develop and implement strategies for resubmission of denied claims ensuring maximum reimbursement Coding and Documentation Support Verify the accuracy and completeness of coding CPT ICD10 HCPCS used in outpatient claims Provide recommendations and corrections to improve documentation for accurate billing Work with clinicians and administrative teams to ensure proper documentation practices Training and Process Improvement Conduct training sessions for teams on claim submission denial handling and coding updates Qualifications Education and Certification Bachelor s degree in a sciencerelated field or Paramedical studies Certification in medical coding e g CPC CCS is required Knowledge and Skills Strong knowledge of UAE healthcare regulatory frameworks DOH DHA MOH Proficiency in coding standards CPT ICD10CM HCPCS and denial codes Experience in analyzing denials and resubmission strategies Familiarity with healthcare billing systems and RCM software Excellent analytical and problemsolving skills Strong communication and interpersonal skills for collaboration and training purposes Experience A minimum of 5 years of relevant experience with at least 3 years in the UAE market You will be redirected to the company website to apply for this position