Claims Officer - Network

About the role

MedNet Egypt is seeking a motivated Network Claims Officer to join its Claims Department. The successful candidate will process and evaluate medical claims in line with coverage scopes and provider contracts, ensuring accuracy and timeliness.

Key responsibilities

• Apply Claims Department policies, procedures, and quality measures to all claim processing activities.
• Conduct medical audits and review received claims against coverage scopes and provider contracts before processing.
• Enter claim data accurately, verify service descriptions, and match benefits according to medical coding rules and policy schedules.
• Generate daily, weekly, and monthly reports as required by supervisors.
• Collaborate with auditors to address audit findings and implement corrective actions.
• Manage workload fluctuations while maintaining quality and meeting monthly targets.
• Report any issues promptly to the direct superior.

Required profile

• Bachelor’s degree in Medicine, Pharmacy, or Dentistry.
• 0‑2 years of experience in a related educational field; insurance experience is a plus.
• Fluent English with strong verbal and written communication skills.
• Excellent time‑management, analytical, and problem‑solving abilities.
• Ability to work under pressure and maintain attention to detail.

Required skills

• Medical coding

What we offer

• Opportunity to develop expertise in healthcare claims processing within a leading managed‑care organization.
• Supportive team environment focused on professional growth.