Key Responsibilities:
Review and analyze medical records, documentation, and billing to ensure accuracy and compliance with Kuwait Ministry of Health regulations and hospital policies.
Assess the appropriateness and validity of medical procedures and treatments.
Verify medical claims and billing submissions for correctness and adherence to insurance and regulatory standards.
Conduct audits of clinical documentation to identify discrepancies, errors, or potential fraud.
Collaborate with healthcare providers and administrative staff to improve documentation quality and compliance.
Prepare detailed audit reports and provide recommendations for corrective actions.
Stay updated on changes in healthcare regulations, coding, and billing standards in Kuwait.
Assist in the development and implementation of audit policies and procedures.
Requirements:
Bachelor’s degree in Medicine, Healthcare Administration, or related field.
Certification in Medical Auditing or Healthcare Compliance preferred.
Minimum 3 years of experience in medical auditing, billing, or healthcare compliance.
Strong knowledge of Kuwait healthcare regulations, billing procedures, and medical coding systems.
Excellent analytical, communication, and report-writing skills.
Attention to detail and integrity in handling sensitive information.