Medical Claims Review Physician
Doctor – Medical Claim Management
Company: Mobizz Elite (Pvt) Ltd
Requirements
- Possess a medical degree (MBBS, MD) from a recognized institution or an equivalent foreign degree; SLMC registration is an added advantage.
- Previous experience in medical claim management, healthcare administration, or medical billing preferred.
- Effective communication skills (verbal and written) to interact professionally with internal and external stakeholders.
- Detail-oriented with a high level of accuracy in claims review and processing.
- Proficiency in using electronic health records (EHR) systems.
Key Responsibilities
- Review and adjudicate medical claims submitted by healthcare providers, ensuring adherence to policies, procedures, and regulatory guidelines.
- Evaluate medical documentations, including patient records, treatment plans, and diagnostic reports, to determine claim validity and appropriateness.
- Communicate with healthcare providers, insurance companies, and patients to obtain additional information or documentation.
- Maintain accurate records of claims processing activities and documentation of decisions.
- Stay current on industry regulations and reimbursement methodologies to ensure compliance and optimize processes.
Location
No: 91, 1/1, Galle Road, Colombo 4
How to Apply
Send your CV to: yasanthi@mobizz.lk