Job descriptions & requirements

Key Responsibilities:

• Review and analyze medical claims for accuracy, completeness, and compliance.
• Verify patient records, treatment details, and billing information.
• Liaise with healthcare providers, insurance companies, and internal teams to resolve discrepancies.
• Identify and flag inconsistent claims.
• Ensure adherence to regulatory and insurance requirements.
• Track and manage claims turnaround times (TAT) to ensure timely processing and settlement.
• Follow up on pending, rejected, or partially approved claims and provide resolutions.

Key Requirements:

• Diploma or Degree in a Clinical Medicine
• At least 3 years’ experience in medical claims analysis, billing, or a similar role
• Strong knowledge of medical terminology and clinical procedures.
• Familiarity with insurance processes and claims management systems.

• Review and analyze medical claims for accuracy, completeness, and compliance.
• Verify patient records, treatment details, and billing information.
• Liaise with healthcare providers, insurance companies, and internal teams to resolve discrepancies.
• Identify and flag inconsistent claims.
• Ensure adherence to regulatory and insurance requirements.
• Track and manage claims turnaround times (TAT) to ensure timely processing and settlement.
• Follow up on pending, rejected, or partially approved claims and provide resolutions.

• Strong knowledge of medical terminology and clinical procedures.
• Familiarity with insurance processes and claims management systems.

• Diploma or Degree in a Clinical Medicine