Medical Claims auditor (Pharmacist Only)

Performing technical audit on medical claims .

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.

Bachelor's Degree in Pharmacy.

Minimum of 1-2 years of experience in reviewing medical claims.

Details-oriented, Time management & 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.

Previous experience in Outpatient Medication