Review and audit medical and dental insurance claims for accuracy and compliance
Assess treatment necessity and validate clinical documentation
Identify and report inconsistencies, coding errors, or potential fraud
Ensure claims adhere to payer policies and medical necessity guidelines
Collaborate with claims processing teams and healthcare providers
Maintain up-to-date knowledge of CPT, ICD, and ADA codes
Prepare detailed audit reports and recommendations
Qualifications:
MBBS or BDS degree (mandatory)
Minimum 2 years of clinical experience, preferably in dental practice
Familiarity with medical and dental coding systems (e.g., ICD-10, CPT, ADA)
Prior experience in claims auditing, medical review, or insurance industry preferred
Excellent analytical, documentation, and communication skills
Strong understanding of healthcare billing procedures and payer guidelines
Preferred:
Certification in Medical Coding or Claims Auditing (e.g., CPC, CPMA)
Experience with dental insurance claims
Proficiency in claim management software or health information systems
Job Type: Full-time
Pay: AED11,000.00 - AED12,000.00 per month
Application Question(s):
Do you have MBBS/BDS ?
Experience:
* Dental Practice/Dental Claims Management: 2 years (Required)
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