MedNet Egypt is one of the leading managed care service organizations that caters to healthcare needs. We are looking for a skilled Reimbursement Claims Officer who will process and audit all medical claims efficiently and accurately according to scope of coverage and provider contracts / SOPs of payers and policy holders.Your JobEnsures processing of reimbursement claims with in the agreed TAT and as per set target.Technically evaluates the claims as per Scope of cover, territorial coverage and proof of payment, Invoices authentic or any suspected fraud in overwritten invoices, high billed amounts for any service more than usual rates for the service in the region or market as per known market practice.Medical claims adjudication as per the standard system-controlled exclusions and policy holder TOB Conduct Medical Audit and review received claims and compare according to scope of coverage and provider contracts before processing / SOPs of payers and policy holders.Creating & submitting daily, weekly, monthly reports according to direct superior requirements.Print out bordereau for all processed claims related to covered cases by PICs and Canceled insured members when required.Separate all invoices once processed according to the PICs (Primary Insurance Companies) in order to send them with the bordereau as scheduled.Respond to mail queries and requests from PIC’s, clients and MNU team.Review medical trends, identify fraudulent cases and bring them to the notice of TL to minimize abuse of medical insuranceYour ProfileBachelor's degree of Medicine, Pharmacy or Dentistry0-2 years of experience in their educational field.Previous experience in the insurance field is a plus.Fluent English languageExcellent verbal and written communication skillsTime management skills.Attention to details.Analytical thinking.Ability to meet tight deadlines.