MedNet Egypt is one of the leading managed care service organizations that caters to healthcare needs. We are looking for a skilled Network Claims Officer who will process and evaluate all medical claims efficiently and accurately according to scope of coverage and provider's contracts.
Your Job
Applying Claims Department policy & procedures and quality measures for processing claims.
Conduct Medical Audit and review of received claims and compare according to scope of coverage and provider contracts before processing.
Processing of claims efficiently & accurately, in order to provide company records of all received claims before end of every month according to direction received by Claims Manager.
Work in high speed and efficiency to achieve monthly targets.
Entering data accurately and accurately check the service description and benefit matching, according to accepted medical coding rules, medical guidelines and policy’s schedule of benefits in order to provide accurate records to the company and PICs.
Checking the audit findings with the direct auditor and doing the corrections requested by the direct auditor, MNU or in house team.
Creating & submitting daily, weekly, monthly reports according to direct superior requirements.
Handle changes in the workload flow in terms of time, quantity and type of requests received with a clear focus on both quality and target.
Report any issues that may arise to direct superior.
Your Profile
Bachelor's degree of Medicine, Pharmacy or Dentistry
0-2 years of experience in their educational field.
Previous experience in the insurance field is a plus.
Fluent English language
Excellent verbal and written communication skills
Time management skills
Analytical and problem-solving skills
Ability to handle stress.
Attention to Details.
To Apply:
https://www.linkedin.com/jobs/view/3764055810
