Medical Claims Auditor

About the Job
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's degree in Pharmacy is a #MUST.
From 1-3 years of experience in the Medical insurance industry /Claims is 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.