Medical Officer (Inpatient Claims)
Cairo, EgyptPosted 6 months ago350Applicants for6 open positions
- 170Viewed
- 33In Consideration
- 51Not Selected
Job Details
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Job Description
- Evaluate inpatient claims to ensure they are accurate and compliant with healthcare regulations and payer guidelines.
- Assess the medical necessity of inpatient services provided and ensure that the documentation supports the claims.
- Work closely with clinical staff, billing teams, and insurance companies to resolve discrepancies and facilitate the claims process.
- Assist in developing and updating policies related to inpatient claims processing and compliance.
- Participate in audits and reviews to improve the accuracy of claims and reduce denials.
- Evaluate inpatient claims to ensure they are accurate and compliant with healthcare regulations and payer guidelines.
- Assess the medical necessity of inpatient services provided and ensure that the documentation supports the claims.
- Work closely with clinical staff, billing teams, and insurance companies to resolve discrepancies and facilitate the claims process.
- Assist in developing and updating policies related to inpatient claims processing and compliance.
- Provide training to clinical and administrative staff on documentation standards and coding requirements.
- Participate in audits and reviews to improve the accuracy of claims and reduce denials.
Job Requirements
- Physicians only, BSC in medicine & surgery
- 3 years clinical experience not including internship year
- Experience in health insurance companies or TPA companies
- Experience in inpatient claim adjudication and processing
- Experience in coding (ICD10 AM, CPT and ACHI) is a plus
