Claims Retrospective Associate - Fluent English (Physicians only) (Cairo, EG)

Allianz
Cairo
Workplace: HybridFull timeFunction: Insurance & ActuarialExperience: 1-3 yearsEducation: bachelorsSkills: ["Communication","Analytical","Attention to detail","Teamwork"]

Medical claims reviewer role combining physician expertise with claims operations. You will assess inpatient/outpatient claims for medical necessity, accuracy, and policy compliance, collaborating with claims teams to support adjudication while maintaining high-quality service in a fast-paced environment.

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FursaFursa
Allianz
Allianz
3 months ago

Claims Retrospective Associate - Fluent English (Physicians only) (Cairo, EG)

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Last checked: 12 hours agoStatus: Live

Job Summary

Medical claims reviewer role combining physician expertise with claims operations. You will assess inpatient/outpatient claims for medical necessity, accuracy, and policy compliance, collaborating with claims teams to support adjudication while maintaining high-quality service in a fast-paced environment.
Location: Cairo
Workplace: Hybrid
Employment Type: Full time
Job Function: Insurance & Actuarial

Key Responsibilities

  • •Conduct clinical assessments of inpatient and outpatient medical claims to ensure accuracy and compliance with policy terms and clinical guidelines.
  • •Validate diagnoses, procedures, and services against medical records and policy terms.
  • •Identify discrepancies, overutilization, or non-compliance with guidelines.
  • •Collaborate with claims teams to support adjudication decisions and ensure alignment with medical policies and regulatory requirements.
  • •Contribute to team and departmental productivity targets to achieve agreed SLA and provide high-level customer service.

Key Requirements

  • •Bachelor of Medicine and Surgery (Physician) in Internal Medicine or Physical Therapy
  • •1-3 years of clinical practice or medical review experience
  • •Familiarity with ICD, CPT, DRG coding and insurance guidelines
  • •Strong analytical and decision‑making skills with high accuracy and attention to detail
  • •Excellent written and verbal communication in English; legally permitted to work in-country
Experience:1-3 yearsHealthcareInsurance
Education:Bachelor's
Skills:CommunicationAnalyticalAttention to detailTeamwork
Languages:English
Tech Stack:ICDCPTDRGMS Office

Company Brief

Allianz
Global insurance and financial services group offering property-casualty insurance, life and health insurance, asset management, and corporate risk solutions to individuals, businesses, and institutions across more than 70 countries.
Industry: Insurance
Company Size: Enterprise (1,001+ employees)
Revenue: USD 1B+
Growth: Public Company
Valuation: Public Company (Market Cap in USD)
Funding: IPO / Publicly Listed
Headquarters: Munich, Germany
Founded: 1890
WebsiteLinkedIn