Are you ready to make a significant impact in the healthcare industry? We are seeking a highly motivated and meticulous Claims Auditor to join our dynamic Resubmission Unit in Giza, Egypt! This is an exceptional on-site opportunity for an experienced professional to ensure the highest standards of accuracy and compliance in medical claims processing.

Overview: As a Claims Auditor in our Resubmission Unit, you will be at the forefront of our quality assurance efforts, meticulously reviewing and validating medical claims. Your expertise will be crucial in maintaining the integrity of our claims operations and ensuring adherence to industry regulations. This role is perfect for someone passionate about precision and committed to driving excellence in healthcare administration.

Responsibilities:

• Conduct thorough audits of resubmitted medical claims to verify accuracy, completeness, and compliance with established policies and procedures.

• Identify discrepancies, errors, and potential areas of non-compliance in claims documentation and processing.

• Collaborate with internal teams to resolve complex claim issues and implement corrective actions.

• Provide detailed feedback and recommendations for process improvements to enhance efficiency and reduce future errors.

• Maintain comprehensive and accurate audit records, ensuring proper documentation for all reviewed claims.

• Stay up-to-date with relevant healthcare regulations and industry best practices to ensure continuous compliance.

Skills & Technologies: This role demands a sharp eye for detail and a strong understanding of medical claims processes. You will leverage your expertise in Auditing, Medical Claims, and Quality Assurance to excel. Proficiency in data analysis and standard office software is also essential.

Growth Opportunities: We are committed to your professional development. As an integral part of our team, you will have opportunities to deepen your expertise in medical claims auditing, contribute to significant process improvements, and potentially mentor junior team members. Your contributions will directly influence the quality and efficiency of our operations.

Team & Culture: Join a collaborative and supportive team environment where precision and quality are paramount. We foster a culture of continuous learning and mutual respect, encouraging every team member to contribute their unique skills and perspectives. Located in the vibrant city of Giza, Egypt, our on-site team thrives on collective success.

Impact: Your work as a Claims Auditor will directly impact the financial health and operational integrity of our organization, ensuring fair and accurate processing for all stakeholders. You will play a vital role in upholding our commitment to excellence and trust within the medical/healthcare sector.

Requirements

• Experience: A minimum of 2-5 years of proven experience in medical claims auditing, quality assurance, or a related field within the healthcare industry.

• Skills:

  • Demonstrable expertise in Auditing and Medical Claims.

  • Strong background in Quality Assurance and regulatory compliance.

  • Exceptional Attention to Detail and analytical skills.

  • Proficiency in Data Analysis and reporting.

  • Excellent Problem-Solving and critical thinking abilities.

  • Effective Communication Skills, both written and verbal.

  • Familiarity with Healthcare Administration processes.

  • A commitment to Process Improvement and meticulous Documentation.

• Career Level: This is an Experienced level position, ideal for professionals ready to take on significant responsibility and contribute immediately.