Roles & Responsibilities
· Work individually and conduct data – driven audits of healthcare claims, checking and
· evaluating accurately the medical records of the members to assess any discrepancy in
· the billing of services or regarding the justification of the procedures as per the known
· medical standards of each.
· Utilizing experience and medical resources interprets medical records and test results
· and provides assessment accordingly
· Attend relevant trainings of the regulator and update the team in relation to the audit
· aspects.
Department / Functional Area
Insurance / Underwriting / Surveying / Actuary