Job Description

📍 Location: [Andalusia hospital maadi ] | 🕒 Full-Time | 🏥 Healthcare / Medical Insurance Sector

Are you a medical professional with a sharp eye for detail and a passion for quality assurance? We’re looking for a Claims Medical Audit Supervisor to lead and optimize the audit of Inpatient, Outpatient, and Emergency medical claims—ensuring accuracy, completeness, and alignment with insurance policies to maximize approvals and reduce rejections.

🔍 Key Responsibilities:
Supervise and audit medical claims to ensure they meet required standards and contractual terms.

Verify all necessary documentation, including lab/radiology reports, approvals, signatures, and stamps.

Align patient records with payer requirements to ensure coverage and eligibility accuracy.

Coordinate with internal departments (Medical Records, Finance, Corporate Sales, Front Office) to complete claim files.

Ensure clear and compliant medical terminology is used in all submitted claims.

Implement corrective actions to reduce claim rejection rates and support continuous process improvement.

Lead and support the medical auditing team; resolve escalated claim-related issues efficiently.

🎓 Qualifications:
Bachelor’s degree in Medicine (MBBCh or equivalent) – required

3–5 years of experience in medical claims management, with 1–2 years in a supervisory role

Excellent analytical, communication, and leadership skills

Proficient in Microsoft Office (Excel, Word, Outlook)

Strong English communication (written & verbal)

Familiarity with healthcare business processes and insurance policy structures

🌟 What We Offer:
A collaborative work environment within a leading healthcare group

Opportunities for professional growth and leadership

The chance to make a real impact on the financial and operational health of the organization