- Performing technical audit on medical claims.
- 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.
Bachelor's Degree in Medicine and Surgery.Minimum of 1-3 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.