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Nationality
Any Nationality
Gender
Not Mentioned
Vacancy
1 Vacancy
Job Description
Roles & Responsibilities
Key responsibilities/What you do:
- Manages routine daily claims administration work.
- Coordinates work flow & meet deadlines.
- Evaluates OP claims with regards to eligibility.
- Apply nextcare cost containment protocols for OP claims at the retrospective review level
- Attends calls and e-mails from insurance companies, clients, and providers.
- Makes suggestions to improve service.
- Increase efficiency, minimize errors, and reduce administration time through AI-powered automation.
Key requirements/What you bring
- Fluency in MS Office (Excel, Word, Outlook, PowerPoint) and general internet navigation and research skills
- Certified Medical Coder is preferable, with familiarity in AI-driven coding tools being beneficial
- Experience with AI tools and platforms relevant to claims processing and administration, enhancing operational efficiency and accuracy.
Desired Candidate Profile
Description:
The Medical Claims - Officer will provide quality service to clients, promptly and effectively assesses and process OP claims according to operations set standards
Key requirements/What you bring
- Bachelor s of Pharmacy / Dentistry / Medicine / Nursing / Physiotherapist / Paramedics
- Medical Practical Experience (reputable insurance provider, broker or a TPA experience a plus) OR Entry Level
- Physically fit to carry out duties.
- Certified Medical Coder [Preferable]
- Legally permitted to work in the country of operations.
Company Industry
- Insurance
Department / Functional Area
- Insurance
- Underwriting
- Surveying
- Actuary
Keywords
- Medical Claims Officer
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Nextcare Egypt
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