Medical Officer - Healthcare Billing Services
Review clinical documentation to assess the appropriateness of private health insurance claims
* Travel across Ireland (Full licence required)
* Must be currently residing in Ireland / No Via sponsorship with this role
* Monday to Friday
* Manage Insurance Case Loads
* Part-time or full-time.
* Must be registered with the IMC
* Pharma/Industry experience required
This position involves reviewing clinical information and, when appropriate, composing appeal letters to private health insurers. Staying current with relevant clinical practices and guidelines is essential. A comprehensive understanding of health insurance policies, terms, conditions, and Schedules of Benefits is necessary; training will be provided to the successful candidate.
Key Responsibilities:
* Review clinical documentation to assess the appropriateness of private health insurance claims.
* Prepare and submit appeal letters to private health insurers when claims are denied or underpaid.
* Maintain up-to-date knowledge of clinical practices and guidelines
* Understand and apply health insurance policies, terms, conditions, and Schedules of Benefits.
* Travel to various hospitals across Ireland, spending approximately 30-40% of work time away from home. Efforts will be made to assign hospitals within a commutable distance when possible.
Candidate Requirements:
* A minimum of 3 years’ experience as a General Practitioner or hospital doctor.
* Registration with the Irish Medical Council and maintenance of Continuing Medical Education (CME) credits.
* Non-clinical medical indemnity is required; the company will reimburse this expense.
* Experience within the Irish healthcare system is highly advantageous.
* Experience with private health insurance processes is desirable.
* Proficiency in Microsoft Excel and Word is required.
* The successful candidate will undergo comprehensive training upon recruitment.
For a confidential conversation please call Shirley on 086 783 1786
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