Medical Claims Auditor

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'sdegree in Pharmacy is a #MUST.
• From 1-3 years of experience intheMedical insurance industry / #Claimsis a #MUST
• Details oriented, Time management & Team-players.
• Males are preferred (Military Service should be exempted/completed)
• Very Good English Language skills are required.
• Strong communication skills.