Job description for Admin Medical Advisor at Sequis Life
Key Responsibilities:
- Help compile and manage data on healthcare providers, including hospital classifications and tariff reviews.
- Provide administrative support in complex medical case reviews, focusing on documentation of medical necessity, benefits eligibility, and policy exclusions.
- Help maintain and update medical guidelines and insurance practices in line with current clinical standards.
- Support the preparation of reports related to provider performance, claims review, and healthcare cost efficiency.
- Coordinate with internal and external stakeholders to ensure accurate documentation and effective communication across teams.
Qualification:
- Bachelor’s degree in Nursing.
- Experience in medical administration or insurance is a plus.
- Strong attention to detail and organizational skills.
- Able to analyze medical data and assist in decision-making.
