Medical Claims Officer

Required Skills

The role requires a Bachelor of Medicine and Surgery (BSc) with 3-5 years of experience in medical claims auditing, project cost planning, and reporting. Experience in a healthcare setting is highly desirable. Strong computer skills in MS Office, especially Excel, along with excellent analytical, problem-solving, interpersonal, communication, and presentation skills are essential. The candidate should also possess good project background and technical writing abilities.

Job DescriptionTITLE: Medical Claims OfficerTEAM/PROGRAMME: Operation& Health program LOCATION: Cairo, EgyptGRADE: 4CONTRACT LENGTH: Pending Doner ApprovalCHILD SAFEGUARDING: (select only one)Level 2: either the post holder will have access to personal data about children and/or young people as part of their work; or the post holder will be working in a regulated position (accountant, barrister, solicitor, legal executive); therefore, a police check will be required (at standard level in the UK or equivalent in other countries).Role PurposeThe Medical Claims Officer is responsible for controlling and monitoring project total medical expenditure including verifying and checking invoices and claims from providers, suppliers, vendors, and subcontractors to ensure that all project expenditures are captured and properly recordedScope Of RoleReports to: Senior Program ManagerStaff reporting to this post: 2 Medical claims Coordinators, + 1 adminRole Dimensions: Close coordination with the Health Team, Finance Unit, and contracted health care providers.Key Areas Of Accountability Manage medical claims reviewing process and provide reports related to cost control and planning. Review the medical reports, requirements, and documents received from health providers Review price lists and create comparisons among providers during the contracting phase Provide a final report for all claims with all comments and deductions Monitor status of all referrals, commitments, and claims up to the closure of the project Assist in preparing monthly spending and forecasted reports. Ensure open communication channels with providers Provide cost-controlling support for all project activities which includes forecasting and variation reporting Review and tracking all medical cash payment for beneficiaries Participate in improving medical reports, documentations Contribution to increase accuracy in medical reports by health providers Carrying out tasks as requested by line managers as needed. Participating in medical audits to enhance the medical claims documentation. Ensuring the timeliness and completeness of the claims reporting process.BEHAVIOURS (Values in Practice)Accountability holds self-accountable for making decisions, managing resources efficiently, achieving and role modelling Save the Children values holds the team and partners accountable to deliver on their responsibilities - giving them the freedom to deliver in the best way they see fit, providing the necessary development to improve performance and applying appropriate consequences when results are not achieved.Ambition sets ambitious and challenging goals for themselves and their team, takes responsibility for their own personal development and encourages their team to do the same widely shares their personal vision for Save the Children, engages and motivates others future orientated, thinks strategically and on a global scale.Collaboration builds and maintains effective relationships, with their team, colleagues, Members and external partners and supporters values diversity, sees it as a source of competitive strength approachable, good listener, easy to talk to. Creativity: develops and encourages new and innovative solutions willing to take disciplined risks.Integrity honest, encourages openness and transparency; demonstrates highest levels of integrityQualifications Bachelor of medicine is required Certificate in auditing, cost control is highly desirableExperience And Skills Bachelor's degree in medicine and surgery BSC is must 3-5 years experience in medical claims auditing, project cost planning and reporting Experience in healthcare setting is highly desirable High computer skills on MS office programs especially MS Excel Demonstrate strong interpersonal, communication and presentation skills Strong analytical and problem-solving skills and meticulous Possess good project background and technical writing ability and skills. Mature, proactive, resourceful and hands-on with good initiative. Good command in English, both verbal and written, requiredAdditional Job ResponsibilitiesThe duties and responsibilities as set out above are not exhaustive and the role holder may be required to carry out additional duties within reasonableness of their level of skills and experience.Equal OpportunitiesThe role holder is required to carry out the duties in accordance with the SCI Equal Opportunities and Diversity policies and procedures.Child SafeguardingWe need to keep children safe so our selection process, which includes rigorous background checks, reflects our commitment to the protection of children from abuse.Safeguarding Our StaffThe post holder is required to carry out the duties in accordance with the SCI anti-harassment policyHealth and SafetyThe role holder is required to carry out the duties in accordance with SCI Health and Safety policies and procedures.JD written by: Rabab Bennis Date: Jan 2019Updated By: Omar El. Noman Date: Augst 2026Reviewed By: Qais Jassar Date : Augst 2026