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Job Description
- Check the analysis report before sending from medical analyst
- Issue the abusing report periodically depending on cases discovered to be sent to the concerned departments .
- Follow up with internal departments about final findings gathered to take their corrective actions
- Communicate new rules to overcome abusing cases to concerned department.
- Detect hospitals with high outpatient services , claims without consultations or claims with act names not matches with the description or gender or age then communicate with concerned departments to apply case management technique
- Check and reporting loss ratios clients periodically to take priority in analysis process
- Recommendations restrictions while renewal contracts with client
- Raising flag while renewal the contract about the recommendations required to avoid extra loss Vs benefits
Job Requirements
- One year experience in Medical Analysis field
- Minimum 1 year experience in insurance companies
- Graduated from a medicine or pharmaceutical field
