QaranJobs.com – somali jobs – somalijobs – qaranjobs – Qaran Jobs Somali Jobs
Baraka Insurance Ltd
Senior Medical Audit Officer – Mogadishu, Somalia
Job Profile; Senior Officer- Medical Audit based in Mogadishu but 30% travel across Country
Reporting to: Operation Manager
Staff reporting to role; N/A
About us;
BARAKA INSURANCE Ltd was founded as limited company in 2018. Our company provides cooperative insurance which complies with Islamic Shariah laws on the bases of a Wakalah (agency) also known as wage. The company operates on the principles of mutual protection, co-operative risk and profit sharing.
Baraka Insurance provides an extensive range of protection plans to suit your diverse needs. From medical, motor takaful and home coverages to commercial cover, employee benefits and many more. Our products and services be it for individuals or businesses assure the best quality of care and security that you need.
Job Purpose;
To be responsible for performing providers Audit Campaign, and identifying unfavorable trends in providers billing, maximize audit findings and recovery through providing solid audit ground.
Main tasks
The Medical officer will be in charge;
ü Assists the Line Manager in implementing and managing claims denial, approvals communication and management with TPA, health care provider, insured member and health care regulators.
ü Conducts medical audit for fraud, waste or abuse with health care providers.
ü Assists in the review of claims which are suspected for abuse and medical claims audit
ü Responds for home country members approval and claim coordination
ü Implements knowledge sharing, risk instigations, team training by closely working with partner hospitals and clients.
ü Performs audit of BTI performance
Skills and Qualifications
- Completed MBBS / MBChB/ Equivalent Degree.
- Proficient knowledge of HAAD
- Working knowledge of general practices for medical insurance procedures.
- At least 1 – 3 years’ experience in a similar role in Healthcare Audit with coding experience preferably medical coding experience.
- Freshers with MBBS / MBChB/ Equivalent Degree may also apply.
- Good communication skills in English both written & oral.
- Candidates having work experience as Medical Doctors in private/Government Hospitals in the Somalia/Somaliland (Preferable).
- Coding certification; CPC & IPDRG (Preferable).
- Proven project management experience along with strong communication skills – both written and verbal
- Strong organizational skills
- Analytical and problem solving capability
- Demonstrated ability to meet deadlines in a flexible environment
- Demonstrated leadership ability
How to apply
Qualified candidates with the required skills are invited to submit their applications accompanied by detailed curriculum vitae as a single document i.e. with the cover letter being on the first page and the CV starting on the second page, detailing three work related referees and contacts to recruitment@barakatakaful.com and received on or before 5.00PM on 10th Sep 2022 with the subject line “ Senior officer- Medical audit– Mogadishu ”. Please do not attach any other documents while sending your applications, if required they will be requested at a later stage.
………………………………………………………………………………………
QaranJobs.com
………………………………………………………………………………………
PLEASE JOIN US – QARAN JOBS
Follow us on our Social Media:
Telegram: https://t.me/qaran_jobs
Facebook Page: https://www.facebook.com/QaranJobs.so
Facebook Group: https://www.facebook.com/groups/somaliajobs
Linkedin: https://so.linkedin.com/company/qaranjobs
Twitter: https://twitter.com/QaranJobs
Instagram: https://www.instagram.com/qaranjobs
Application: https://play.google.com/store/apps/details?id=com.qaran.jobs
………………………………………………………………………………………
To apply for this job email your details to recruitment@barakatakaful.com