Medical Claims Coordinator
Mersal
Posted 30+ days ago
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Nationality
Any Nationality
Gender
Not Mentioned
Vacancy
1 Vacancy
Job Description
Roles & Responsibilities
- Performing technical audit on medical claims (inpatient and outpatient).
- 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.
Desired Candidate Profile
- 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.
Company Industry
- NGO
- Social Services
- Community Services
- Non-Profit
Department / Functional Area
- Doctor
- Nurse
- Paramedics
- Hospital Technicians
- Medical Research
Keywords
- Medical Claims Coordinator
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