Submission & Resubmission Officer

Responsibilities

• Submit claims and required documentation accurately and within established timelines
• Review rejected or denied claims and prepare resubmissions after correcting identified issues
• Verify claim completeness, coding, and supporting documentation before submission
• Monitor claim status and follow up on pending, rejected, or returned claims
• Investigate rejection and denial reasons and coordinate with relevant departments to resolve issues
• Maintain accurate records of submissions, resubmissions, and claim outcomes
• Ensure compliance with payer guidelines, company policies, and regulatory requirements
• Communicate with insurance companies, third-party administrators (TPAs), and internal stakeholders
• Prepare daily, weekly, and monthly reports on submission activities and rejection trends
• Escalate complex or recurring issues to the Team Lead or Manager
• Participate in quality improvement initiatives to reduce rejection rates

Requirements

• Bachelor's degree or diploma in Healthcare Administration, Medical Records, Business Administration, or a related field
• 1–3 years of experience in medical claims submission, revenue cycle management, or healthcare operations
• Familiarity with insurance claim processing and payer requirements

About the Company

NMC Healthcare is a leading healthcare provider offering a wide range of medical services across the region.