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Medical Claims Auditor (Doctor)
Downtown, Cairo
Posted 2 months ago
218Applicants for1 open position
  • 106Viewed
  • 0In Consideration
  • 0Not Selected
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Job Details

Experience Needed:
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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.
  • Decision on high cost and complicated cases with providers. 
  • 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 management any irregularity noticed during the audit and/or closing of claims.

Job Requirements

  • Must be graduated from Faculty of Medicine.
  • From 1-3 years of experience in Medical insurance/TPA industry is a MUST
  • Details oriented, Time management & Team-players.
  • Males are preferred (Military Service should be exempted/completed)
  • Very Good English Language skills is required.
  • Strong communication skills.

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JobsMedical/HealthcareMedical Claims Auditor (Doctor)