Medical Claims Coordinator

The Medical Claims Coordinator is responsible for auditing and verifying all medical records and financial claims received from healthcare service providers, ensuring accuracy, compliance with SCI guidelines, and timely claim submissions. The role supports the EKN2 project aimed at providing safe and equitable access to quality SGBV prevention and response services for displaced Sudanese people in Egypt.

Responsibilities

• Validate medical information and claims received from healthcare service providers.
• Proofread and verify data for completeness and accuracy, identifying and correcting errors or omissions.
• Communicate with healthcare providers and SCI Medical Coordinators to verify and clarify information and documentation.
• Review medical records, patient histories, billing documents, and related files to determine coverage, payment amounts or overpayments, and patient conditions.
• Ensure medical bills comply with agreed contract price lists.
• Maintain effective professional communication with all healthcare providers and suppliers.
• Ensure full compliance with SCI finance and procurement policies, procedures, and guidelines.
• Accurately enter and manage data related to medical bills and claims.
• Prepare regular reports by collecting, analyzing, and summarizing relevant information.
• Draft necessary correspondence, forms, invoices, and other required documents.
• Perform other related tasks assigned by the line manager.
• Ensure the mainstreaming of SCI’s Child Safeguarding Policy in all program activities.
• Uphold and ensure adherence to SCI policies and procedures to maintain operational efficiency.
• Review MEAL weekly Cases.

Requirements

• Bachelor’s degree in medicine.
• Proven experience in reviewing and auditing medical claims is essential.
• 1–3 years of successful experience in projects with a reputable humanitarian NGO in Egypt, preferably in the health sector.
• Strong interpersonal and communication skills, including negotiation, influencing, and coaching abilities.
• Fluency in English and Arabic (spoken and written) required.
• Commitment to Save the Children’s values and principles.

Skills

• Medical Claims Auditing
• Medical Records Verification
• Claims Review
• Healthcare Compliance
• Project Experience in Humanitarian Health
• Negotiation Skills
• Influencing Skills
• Coaching Abilities
• English Language Proficiency
• Language Proficiency in Arabic

Languages

English, Arabic