MedNet Egypt is one of the leading managed care service organizations that caters to healthcare needs. We are looking for a skilled Case Management Reviewer who will provide services -mainly through (Phone Calls, Emails, and online) - related to medical evaluation/authorizations for Inpatient insured members/providers and to assist with other administrative issuesYour Job: Assess medical necessity and appropriateness for inpatient services and provide authorizations accordingly.Perform daily auditing of inpatient claims from the claims department to ensure compliance and accuracy. Manage queries via phone, email, and system from providers, insurance companies, and insured members.Monitor admitted cases, review treatment plans, ensure cost control, and negotiate with hospitals when needed.Review medical procedures against policy terms and international medical guidelines (e.g., Medscape, Mayo Clinic). Discuss treatment plans with physicians and arrange second opinions where needed for validation.Deliver responsive, high-quality service to clients to maximize satisfaction and adherence to SLAs.Guide patients to optimal care options and maintain a referral matrix of preferred providers. Compile daily, weekly, and monthly reports on departmental performance, savings, and medical trends.Maintain accurate and updated medical records, investigation results, and approval files.Support the development of tools to streamline the case management cycle and pricing benchmarks. Respond to inpatient requests and queries from international insurance accounts professionally and efficiently.Your Profile Bachelor’s degree in medicine (essential); 2–4 years' field experience. Previous exposure to medical call centers, claims handling, or case management within a TPA or insurer is a plus.Proficient in MS Office (Word, Excel, PowerPoint); database management experience. Familiarity with local healthcare services and provider networks is an advantage.Excellent written and verbal English; strong interpersonal and negotiation skills.Analytical ThinkingOrganizational SkillsDecision-Making skillsCustomer-Centric Mindset