Healthcare Audit Manager

Experience level Experienced Hire
Job details sector Health
The purpose of the job is to manage the inpatient medical claims cost in the assigned medical providers and develop the relationship with medical providers.  There are additional responsibilities of assisting in medical complex cases to ensure proper medical case management for the insured members and implement investigations, procurement strategic action plans and audit strategic action plans.
TASK OVERVIEW (amongst others):
You will:
  • Provide guidance and expert medical direction to the medical claims teams, insurance departments of the medical providers;
  • Investigate and audit medical record within assigned medical provider;
  • Represent AXA effectively both in front of providers as well as customer;
  • Build relations with key stakeholders in assigned medical providers;
  • Ensure that the medical services provided to AXA members in the designated network of providers are up to the highest medical standards;
  • Regularly visit to AXA members (critical medical cases) in assigned medical providers;
  • Be responsible of medical case management within assigned medical providers
Technical skills:
  • Requires a sound knowledge of all medical insurance, pricing fee / arrangements and billing policies;
  • Demonstrates an expert knowledge of medical conditions, treatments and procedures in order to guide claimants and challenge medical practitioners and healthcare providers;
  • Possesses a good knowledge of Microsoft Office such as Word, Excel, and Powerpoint .
Academic Qualifications:
  • Completed tertiary education in MBBS or Medicine.
  • With minimum 3 years work experience in Healthcare Insurance specifically in Claims, Approvals and in Network Provider relationship.
Behavioral competencies:
  • Strong in Customer Service Orientation
  • Excellent Relationship Building skill
  • Good Spoken and Written communication skill
Would you like to wake up every day driven and inspired by our noble mission and to work together as one global team to empower people to live a better life?  Here at AXA we strive to lead the transformation of our industry. We are looking for talented individuals who come from varied backgrounds, think differently and want to be part of this exciting transformation by challenging the status quo so we can push AXA - a leading global brand and one of the most innovative companies in our industry - onto even greater things. 
In a fast-evolving world and with a presence in 64 countries, our 166,000 employees and exclusive distributors anticipate change to offer services and solutions tailored to the current and future needs of our 103 million customers.

With a workforce of over 1,000 employees, 44 branches & retail shops region-wide, more than 1 million customers and 2015 gross written premium of over US$ 963 million, AXA is one of the largest international player in the GCC. Present in the region for more than 65 years, AXA in the Gulf offers a wide range of insurance products and services for corporate, SME and individual customers.
Our business is to protect people over the long term. We emphasis on designing reliable solutions to meet the needs of our customers, manage risks in a professional way, treat our partners fairly, develop a work environment built on strong values, relationship and trust
We also believe that we have a role to play in protecting the environment, supporting the communities in which we operate, and more broadly in helping to create stronger and more sustainable societies. This is part of creating a sustainable, long-term business, and becoming the preferred company for our customers, employees, and other stakeholders.
AXA Gulf has been awarded General Insurance Company of the Year for 2nd consecutive year and Health Insurance Company of the Year at the 2015 Middle East Insurance Industry Awards (MIIA), Insurer of the Year and Personal Lines insurer in 2016 at the MENA Insurance Awards and Best Motor Insurance Product by the Banker Middle East in both UAE & KSA.
As part of AXA’s corporate responsibility and its commitment to building better understanding about the health risks faced by individuals and the society, the company achieved a new Guinness world record for the most blood cholesterol readings in 8 hours at a single venue.
We are investing significantly in the Gulf region and we recognise the important role employees have in the success of our business.
We offer excellent opportunities for motivated and talented candidates whether at entry level or at c-suite level.
We value diversity and we encourage applicants of various backgrounds and nationalities to join our team.