About The Role

Level 2: either the post holder will have access to personal data about children and/or young people as part of their work; or the post holder will be working in a ‘regulated’ position (accountant, barrister, solicitor, legal executive); therefore, a police check will be required (at ‘standard’ level in the UK or equivalent in other countries).

ROLE PURPOSE

The Medical Claims Officer is responsible for controlling and monitoring project total medical expenditure including verifying and checking invoices and claims from providers, suppliers, vendors, and subcontractors to ensure that all project expenditures are captured and properly recorded

SCOPE OF ROLE

Reports to: Senior Program Manager

Staff reporting to this post: 2 Medical claims Coordinators, + 1 admin
Role Dimensions : Close coordination with the Health Team, Finance Unit, and contracted health care providers.

KEY AREAS OF ACCOUNTABILITY

Manage medical claims reviewing process and provide reports related to cost control and planning.
Review the medical reports, requirements, and documents received from health providers Review price lists and create comparisons among providers during the contracting phase
Provide a final report for all claims with all comments and deductions
Monitor status of all referrals, commitments, and claims up to the closure of the project
Assist in preparing monthly spending and forecasted reports.
Ensure open communication channels with providers
Provide cost-controlling support for all project activities which includes forecasting and variation reporting
Review and tracking all medical cash payment for beneficiaries
Participate in improving medical reports, documentations
Contribution to increase accuracy in medical reports by health providers
Carrying out tasks as requested by line managers as needed. • Participating in medical audits to enhance the medical claims documentation. • Ensuring the timeliness and completeness of the claims reporting process.

BEHAVIOURS (Values in Practice )

Accountability

holds self-accountable for making decisions, managing resources efficiently, achieving and role modelling Save the Children values
holds the team and partners accountable to deliver on their responsibilities - giving them the freedom to deliver in the best way they see fit, providing the necessary development to improve performance and applying appropriate consequences when results are not achieved.

Ambition

sets ambitious and challenging goals for themselves and their team, takes responsibility for their own personal development and encourages their team to do the same
widely shares their personal vision for Save the Children, engages and motivates others
future orientated, thinks strategically and on a global scale.

Collaboration

builds and maintains effective relationships, with their team, colleagues, Members and external partners and supporters
values diversity, sees it as a source of competitive strength
approachable, good listener, easy to talk to.

Creativity:
develops and encourages new and innovative solutions
willing to take disciplined risks.

Integrity

honest, encourages openness and transparency; demonstrates highest levels of integrity

QUALIFICATIONS

Bachelor of medicine is required
Certificate in auditing, cost control is highly desirable

EXPERIENCE AND SKILLS

Bachelor’s degree in medicine and surgery BSC is must
3-5 years’ experience in medical claims auditing, project cost planning and reporting
Experience in healthcare setting is highly desirable
High computer skills on MS office programs especially MS Excel
Demonstrate strong interpersonal, communication and presentation skills
Strong analytical and problem-solving skills and meticulous
Possess good project background and technical writing ability and skills.
Mature, proactive, resourceful and hands-on with good initiative.
Good command in English, both verbal and written, required

Additional job responsibilities

The duties and responsibilities as set out above are not exhaustive and the role holder may be required to carry out additional duties within reasonableness of their level of skills and experience.

Equal Opportunities

The role holder is required to carry out the duties in accordance with the SCI Equal Opportunities and Diversity policies and procedures.

Child Safeguarding

We need to keep children safe so our selection process, which includes rigorous background checks, reflects our commitment to the protection of children from abuse.