Associate, Claims Operations

Reliance Health

Employer Active

Posted 11 hrs ago

Experience

1 - 5 Years

Job Location

Cairo - Egypt

Education

MBBS(Medicine)

Nationality

Any Nationality

Gender

Not Mentioned

Vacancy

1 Vacancy

Job Description

Roles & Responsibilities


The Role

As an Associate, Claims Operations, you ll play a key role in ensuring healthcare claims are processed accurately and efficiently. You ll help maintain fairness in the system by validating claims, identifying inconsistencies, and supporting timely reimbursements. If you re detail-oriented and enjoy applying clinical knowledge to solve real-world problems, this role is for you.

What You ll Do

  • Review, validate, and process healthcare claims in line with company policies
  • Ensure claims are accurately recorded and maintained in the system
  • Investigate complex claims and make decisions based on clinical standards and internal guidelines
  • Support timely payment of approved claims within defined service timelines
  • Identify and decline fraudulent or suspicious claims
  • Investigate cases of fraud, waste, and abuse, and escalate findings where necessary
  • Collaborate with provider management teams to resolve provider-related issues
  • Share claims updates and reconciliation details with healthcare providers
  • Provide clinical input on complex care approvals when required
  • Support patient referral decisions in collaboration with the care team

Desired Candidate Profile

What You ll Bring

  • Bachelor s degree in Medicine (MBBS or equivalent)
  • Minimum of 1 year clinical experience as a medical doctor
  • Strong understanding of clinical procedures, terminology, and standards of care
  • Ability to apply clinical knowledge to claims review and decision-making
  • Strong numerical and analytical skills
  • Experience working with data and processing information accurately
  • Clear written and verbal communication skills
  • Proficiency in Microsoft Word and PowerPoint

Nice to Have

  • Experience in claims processing or care approvals

What We Offer

  • Salary: EGP 16,518.19 monthly
  • Hybrid role based in Cairo, Egypt
  • Unlimited leave take the time you need
  • Premium health insurance for you and your family
  • Learning and development allowance to support your growth

Ready to Join Us?

If this sounds like you, we d love to hear from you. Apply today.

Company Industry

  • Medical
  • Healthcare
  • Diagnostics
  • Medical Devices

Department / Functional Area

  • Administration

Keywords

  • Associate
  • Claims Operations

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Reliance Health

https://apply.workable.com/get-reliance-health/j/C2D8DECA04/