Medical Review

4 weeks ago


Riyadh, Saudi Arabia Sawaid Full time

**We are looking for a **" Medical review (physician) "** to join one of the biggest companies Supportive "Healthcare And Health Insurance" in Saudi Arabia.**:
**The location work in (Riyadh)**

**What Will You Do**:

- Evaluating medical records
- Interpreting medical data
- Making diagnoses Based on the review of medical records and data
- Providing expert opinions" In some cases"
- Review and audit the claims medically to reduce claims rejections due to medical reasoning
- Prepare reports on the medical errors found on the claims.
- Discuss &train physicians on medical rejections and proper documentation.

**What are the requirements and qualifications required for the job**:

- Bachelor’s Degree in Medicine, Any additional certifications related to the role will be an added advantage.
- At least 2 years of experience in medical claims auditing with a provider or with payer/ TPA in the KSA is essential.
- Good knowledge of insurance protocols and regulatory guidelines.
- Knowledge of ICD, CPTs, ACHI, and DRG codes
- Should have good IT skills.
- Excellent in English


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