Medical Claims Adjuster (TPA Experience - Outpatient Claims)
Maadi, CairoPosted 7 years ago107Applicants for2 open positions
- 99Viewed
- 24In Consideration
- 75Not Selected
Job Details
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Job Description
- Performing technical audit on medical claims
- Justifying the rejection reasons on system in rejection cases to facilitate the reconciliation process.
- Proper implementation of agreements on claims in collaboration with the audit and processing team
- Audit of invoice, if it is under his job responsibilities.
- Coordination with other adjusters for distribution of the claims
- Escalation of any problematic area to Supervisor.
- Formulate and handle exceptions of claims.
- Report to CPD manager any irregularity noticed during the audit and/or closing of claims.
Job Requirements
- Bachelor degree of Pharmaceutical Sciences or related medical background from a Reputable University is a MUST.
- From 1-3 years of experience in Medical insurance/TPA industry is a MUST
- Details oriented, Time management & Self-motivated competencies are required.
- Males are preferred (Military Service should be exempted/completed)
- Good to Very Good English Language skills is required.
- Ability to work individually and in a team.
- Full time - from Sunday to Thursday (9:00 to 5:30 pm).
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