Description

Job Description

📢 Now Hiring: RCM Medical Auditor – Accumed (Abu Dhabi)

Accumed is seeking an experienced RCM Medical Auditor to join our team in Abu Dhabi.

If you have strong expertise in medical claims auditing — especially with Jawda and Tasneef standards — this is an excellent opportunity to grow within a leading healthcare solutions provider.

🔍 Role Overview

As an RCM Medical Auditor, you will be responsible for auditing coded medical claims to ensure accuracy, compliance, and adherence to UAE and international coding and quality standards. You will collaborate closely with Clinical Coders and RCM teams to identify process gaps, enhance data quality, and support continuous improvement initiatives.


📝 Key Responsibilities

-Conduct retrospective and concurrent audits of coded and insurance-related claim data.
-Ensure compliance with medical ethics and clinical coding guidelines.
-Evaluate claims for accuracy based on DHA standards, Jawda requirements, and Tasneef audit criteria.
-Review payer denials and provide root-cause analysis and corrective action feedback.
-Identify potential hospital-acquired conditions (HACs) and escalate appropriately.
-Document audit findings and communicate timely feedback to relevant teams.
-Collaborate with RCM auditors to strengthen the Quality Audit Program.
-Support training and competency evaluation of new clinical coders.
-Maintain accurate audit trackers and assist in developing improved audit tools.
-Perform additional tasks as assigned by the line manager.


🎓 Job Requirements

-Bachelor’s degree in a medical or science field.
-Coding certification is required.
-Proven experience in Jawda and Tasneef medical auditing in the AD.
-Strong knowledge of ICD-10-CM/PCS, CPT, HCPCS, and related coding systems.
-Advanced understanding of anatomy, physiology, medical terminology, and pharmacology.
-2–3 years of medical claim auditing experience (UAE experience preferred).
-Strong knowledge of UAE insurance protocols.
-Excellent IT and documentation skills.

📨 Apply Now

If you meet the criteria and are looking for a rewarding career opportunity, we’d love to hear from you!