Senior Claims Audit Officer
3 days ago
We're Hiring –
Senior Claims Audit Officer
Location:
Maadi, Cairo, Egypt
Company:
Axon HealthTech
Employment Type:
Full-Time
About Axon HealthTech
Axon is one of Egypt's fastest-growing HealthTech companies, pioneering digital healthcare services such as third-party administration (TPA), medical discount programs (Axon Plus), and corporate wellness solutions. We serve both insured and uninsured populations through innovative, tech-enabled platforms that improve healthcare access, affordability, and efficiency.
Position Overview:
The Senior Claims Audit Officer is responsible for overseeing the review and audit of medical claims to ensure compliance with company policies, medical guidelines, and regulatory standards. The role plays a key part in identifying errors, preventing fraud, and ensuring fair and accurate claim settlements while maintaining high service quality and customer satisfaction.
Key Responsibilities:
• Review and audit medical claims to ensure accuracy and compliance with internal policies and external regulations.
• Identify discrepancies, errors, or potential fraud in claim submissions.
• Provide feedback and recommendations to the claims processing team to improve accuracy and efficiency.
• Prepare regular audit reports and share findings with management.
• Collaborate with medical, legal, and compliance teams to resolve complex cases.
• Ensure SLA timelines for claim auditing are met.
• Support in training junior claims officers and sharing best practices.
• Contribute to the development and update of auditing policies and procedures.
Required Qualifications:
- Bachelor's degree in
Pharmacy
or
Medicine
(required). - Previous experience in medical claims auditing, medical coding, or healthcare insurance is preferred.
- Strong understanding of medical terminology, treatment protocols, and insurance guidelines.
- Excellent analytical skills with high attention to detail and accuracy.
- Solid knowledge of medical claims processes, fraud detection techniques, and regulatory compliance.
- Ability to review and interpret medical reports, invoices, and supporting documents.
- Proficiency in MS Office applications (especially Excel).
- Strong communication and reporting skills.
- Ability to work under pressure and meet strict deadlines.
- Strong problem-solving skills with the ability to handle complex cases professionally.
Why Join Axon?
- Work on impactful healthcare solutions that improve lives.
- Be part of a rapidly growing company with strong growth opportunities.
- Competitive salary and performance-based incentives.
- Flexible and collaborative work environment.
- Health and social insurance coverage.
- Exposure to leadership, innovation, and decision-making in healthtech.
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