Vista previa de la oferta
Medical Doctor - Health Claims & Medical Audit
Insurance
We are seeking a qualified Medical Doctor to join our Health Claims department. The role focuses on supporting claims adjudicators, auditing medical cases, and reviewing hospital invoices to ensure medical necessity, clinical appropriateness, and validity of charges in line with policy terms, provider contracts, and Greek healthcare standards.
Key Responsibilities:
- Provide medical support to claims handlers on complex and high-cost cases
- Review and audit medical claims for medical necessity, appropriateness, and coverage
- Audit mainly inpatient cases (and rarely complex outpatient cases), including length of stay and treatment justification based on the relative medical protocols.
- Review hospital invoices and verify charges against medical documentation, contracts, and KEN/DRG frameworks
- Identify overbilling, unnecessary services, billing errors, and inconsistencies
- Support cost containment and medical quality assurance initiatives
- Communicate with providers and internal teams on medical and billing issues
Requirements:
- Medical Degree (MD) and valid license to practice in Greece
- Clinical experience (hospital experience preferred)
- Good knowledge of the Greek healthcare system, private hospitals, and EOPYY environment
- Experience in insurance, claims review, medical audit, or utilization review is a strong advantage
- Strong analytical skills, attention to detail, and sound medical judgment
- Good computer skills and professional communication abilities
- AI literacy (Gen AI, Data Analysis, MS Copilot, ChatGPT
Preferred:
- Experience in insurance, TPA, or healthcare audit
- Postgraduate studies in Public Health, Health Management, or similar
We offer:
- Health insurance
- Pension plan
- Performance-based bonus
- Employee Share Purchase Plan
- Free roadside assistance
- Free appliance protection insurance
- Travel‑insurance discount
91506 | Customer Services & Claims | Professional | Non-Executive | Allianz Partners | Full-Time | Permanent
Allianz Group is one of the most trusted insurance and asset management companies in the world. Caring for our employees, their ambitions, dreams and challenges, is what makes us a unique employer. Together we can build an environment where everyone feels empowered and has the confidence to explore, to grow and to shape a better future for our customers and the world around us.
At Allianz, we stand for unity: we believe that a united world is a more prosperous world, and we are dedicated to consistently advocating for equal opportunities for all. And the foundation for this is our inclusive workplace, where people and performance both matter, and nurtures a culture grounded in integrity, fairness, inclusion and trust.
We therefore welcome applications regardless of ethnicity or cultural background, age, gender, nationality, religion, social class, disability or sexual orientation, or any other characteristics protected under applicable local laws and regulations.
Great to have you on board. Let's care for tomorrow.