- 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.
Bachelor's degree in Medicine is a #MUST.From 1-3 years of experience in the Medical insurance industry.Details oriented, Time management & Team-players.Very Good English Language skills are required.Strong communication skills.Ability to commit to 40 hours per week (from Sunday to Thursday)