Medical Claims Auditor (Physicia...
Mersal -
Maadi, Cairo
Job Details
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Job Description
- Performing technical audit on medical claims (inpatient ).
- Auditing of invoice and Ensuring that all the medical bills are within the contracted price list and the approval criteria according to Mersal policy.
- Justifying the rejection reasons on system in rejection cases to facilitate the reconciliation process.
- Ensuring the best service given to the patients by providers.
- Report to the direct manager any irregularity or problems noticed during the audit and/or closing of claims.
- Prepares reports by collecting, analyzing, and summarizing information of the reviewed claims to assess the quality of our payment and create a cost effective solution.
- Coordinate workflow & meet deadlines.
Job Requirements
- Bachelor's Degree in Medicine and Surgery or pharmacy.
- Minimum of 2-3 years of experience in reviewing medical claims.
- Details oriented, Time management & Team-players.
- Strong communication skills.
- Working knowledge of the MS Office suite (Word, PowerPoint & Excel).
- Previous experience in the field of NGOs will be an added advantage.
