Resubmission Officer

Experience: Minimum 2 years of recent UAE experience.
🔹Key Responsibilities :
- Perform accurate medical coding based on clinical documentation.
- Review medical records and ensure compliance with DOH Abu Dhabi and insurance guidelines.
- Handle rejected, denied, and pending insurance claims.
- Analyze rejection reasons and take corrective action for successful resubmission.
- Manage daily claim resubmissions through CORTEX and Shafafiya.
- Coordinate with doctors and relevant departments for missing documentation and medical justifications.
- Monitor claim ageing, resubmission deadlines, and recovery rates.
- Identify recurring rejection patterns and minimize revenue leakage.
- Prepare regular rejection and resubmission performance reports.
🔹 Requirements :
- CPC or CCS certification.
- Minimum 2 years of UAE medical coding and resubmission experience.
- Strong knowledge of ICD-10-CM, CPT, and E&M coding.
- Hands-on experience with CORTEX and Shafafiya.
- Good understanding of UAE insurance policies, claim rejections, and resubmission procedures.