Bupa Global

Health Insurance

ClaimsPaymentIntegrityConsultant

Cairo, Egypt FULL TIME Remote Friendly
The Brief

“Claims Payment Integrity Consultant at Bupa Global. Skills: Payment integrity, Provider validation, Claims processing. Review and sign off new bank account information. Review provider information for new providers”

What You'll Achieve.

Mitigate payment of false claims; Ensure payments made to correct payee; Support commercial goals

Industry & Context.

Health Insurance
Problems you'll solve

Good problem solving skills; Prioritisation skills

What They're Looking For.

Must Have

Graduate level with a medical background, Good spoken and written Arabic and English, Computer and numerical skills, Good communicator, Ability to work well alone, Ability to work as part of a team, Good understanding of ‘treating customers fairly’, Delivering compliant services within a regulatory environment

Nice to Have

Multilingual skills

What You'll Do.

Review and sign off new bank account information

Review provider information for new providers

Add new and valid providers to SWAN

Review out of network providers

Refer none valid providers

Respond to customer replies

Validate potential fraudulent behaviour

Contribute to cost containment

Maintain and update customer records

Update records when customer makes contact

How You'll Work.

Team & Collaboration

Engaging with stakeholders; Working closely with Claims Fraud Validation Officers

Communication Scope

Good communicator

Free ATS check

Applying for this Claims Payment Integrity Consultant role?

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