Job Description
Hiring for an Reputed Insurance Company based at Muscat, Oman.
Job Title: Supervisor – Claims Audit & Risk (Medical Insurance)
Job Purpose
We are seeking a medically qualified professional to support Quality Assurance within the medical insurance function, focusing on claims auditing, utilization review, and risk identification with exposure to fraud detection . The role is ideal for candidates with strong clinical and insurance experience looking to expand into fraud and audit leadership.
Experience in utilization review, pre-authorization, medical claims auditing, and exposure to fraud detection and abuse patterns…
Key Responsibilities
- Perform detailed audits of inpatient and outpatient medical claims
- Identify irregularities, billing discrepancies, and potential abuse patterns
- Support investigations into s...