Medical Approval Team Leader (Inpatient)

About the role

MedNet Egypt is seeking an experienced Medical Approval Team Leader to oversee inpatient medical operations. The role ensures that approval requests are processed accurately, meet quality standards, and comply with service level agreements.

Key responsibilities

• Oversee inpatient medical approvals and ensure team productivity aligns with targets and SLAs.
• Conduct daily audits of approvals to verify compliance with coverage policies and procedures.
• Identify and investigate potential fraud or abuse cases from providers or clients.
• Provide medical and technical guidance to staff and support international accounts.
• Plan and schedule manpower to optimize operational efficiency.
• Participate in regional transformation projects and support other MedNet operations as needed.
• Lead, coach, and develop team members to maintain processing quality.
• Review treatment plans against medical guidelines, arrange second opinions, and monitor admitted cases.
• Negotiate hospital costs, secure better treatment options, and maintain referral matrices.
• Handle provider, client, and insurer inquiries to ensure timely resolution.
• Prepare performance and medical trend reports highlighting savings and outcomes.
• Maintain accurate medical records and ensure proper documentation filing.

Required profile

• Bachelor’s degree in Medicine.
• At least four years of experience in a related medical field.
• Experience in medical approval, call‑center, or claims activities within insurance, TPA, or MSO environments is a plus.
• Strong command of English, both written and verbal.
• Excellent leadership, planning, and organizational abilities.
• Analytical, problem‑solving, and decision‑making skills.

Required skills

• Microsoft Office
• Excel
• PowerPoint