وظيفة Claims Auditor - Al Shorouk Hospital

Claims Auditor - Al Shorouk Hospital Cleopatra Hospitals Group Heliopolis, Cairo

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تفاصيل الوظيفة

Performing technical audit on medical claims
Amendment of the rejection reasons on system in rejection cases to facilitate the reconciliation process.
Proper implementation of agreements on claims .
Ensuring ICD & CPT codes are right and in place (data entrance on system) .
Adherence to internal RCM processes .
Coordination with other claim auditors for distribution of the claims.
Escalation of any problematic area.
Follow up with the hospital departments as well as case follow-up managers and medical approvals team regarding insurance requirements, instructions and know the reasons for rejection that should be avoided in the future.
Follow up on the monthly collection ,pending and the reasons for the rejections for each company, as well as the outstanding discount reports before issuing checks or after collection to review monthly claims and settlement.
Ensure that the medical documents required to submit pending and rejected claims are complete and avoid proceeding with them.

متطلبات الوظيفة

Bachelor Of Medicine .
preferable experienced From 1-3 years in Medical claims industry
Details oriented, Time management .
Very Good English Language skills is required.
Strong communication skills.

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دورات مفيدة للمجال

دورات الطب

Established in July 2014, Cleopatra Hospitals Group (“CHG”), is a healthcare investment platform with the aim of enhancing the quality and accessibility of healthcare in Egypt. The platform was formed by Abraaj, a leading private equity investor opera

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