The job holder is responsible to execute strategies under guidance of Manager to sample, analyse, identify and audit medical (including dental where relevant) claims to reduce fraud, wastage, abuse or errors (FWAE) from providers
Job Responsibilities
Execute monthly audit plans and get it approved by Manager
Assists the Manager in issuing monthly audit recoveries report for circulation to management
Prepares monthly remote and on-site Audit Plans
Visits providers to conduct audit
Prepares Audit saving Reports
Job Requirements
Minimum 3 – 5 years experience in Medical Provider Audit
Certification in CPC/CPMA
Minimum Bachelor’s Degree either in medicine or dentistry /paramedic/ healthcare industry
Full Professional Proficiency in English language
Ability to lead the audit from start to finish by coordinating with the Providers