{"id":4123442,"url":"https://alion.io/job/bupa-claims-clinical-auditor","title":"Claims Clinical Auditor","company":{"id":973,"name":"Bupa","domain":"bupa.com","url":"https://alion.io/company/bupa","size_band":"5000+","is_staffing_agency":false,"employer_type":"direct","is_intermediary":false,"listed_via":null,"ats_vendor":"Workable","truth_index":{"grade":"A","score":100,"open_postings":10,"ghost_share":0,"stale_share":0,"repost_share":0,"time_to_fill_p50_days":58,"computed_at":"2026-11-12T10:38:37Z"}},"role":"Finance","role_family":"Finance","seniority":null,"employment_type":"full_time","work_mode":"hybrid","remote_scope":null,"remote_scope_basis":null,"remote_working_hours":null,"hiring_geo_confidence":"structured","locations":["Cairo, Egypt"],"countries":["EG"],"hiring_countries":[],"hiring_countries_total":0,"salary":null,"salary_estimate":null,"experience_years_min":null,"visa_sponsorship":false,"relocation_package":false,"has_equity":false,"technologies":[],"status":"live","first_seen_at":"2026-11-10T00:00:00Z","employer_posted_date":null,"last_verified_at":"2026-11-10T00:00:00Z","board_verified":false,"closed_at":null,"days_open":3,"trust":{"level":"not_scored","repost_count":null,"flags":[],"days_open":3},"description":"Job Description:\nClaims Clinical Auditor\nCairo Egypt\nHybrid working options \nPermanent\nFull time\nBupa Global is the international health insurance division of Bupa. We provide customers who want premium international coverage with products and services to access the healthcare they need anytime around the world whether at home or when studying living travelling or working abroad.\nBupa Global has offices around the world including London and Brighton (UK) Dublin (Europe) Miami (USA) Dubai (UAE in partnership with OIC) Egypt and Hong Kong (China) as well as regional offices in mainland China Singapore the Dominican Republic Bolivia Panama Guatemala and Ecuador.\nWe make health happen\nAs a clinical auditor your role will involve enhancing and upholding the Clinical Audit Strategy. Youll achieve this by proactively analysing data and recommending best practices to ensure that the therapies chosen and benefits utilised during the customer journey offer optimal value for money and are conducted efficiently all while ensuring a positive customer experience. Additionally youll assist in implementing standardised medical care management guidelines throughout the organisation.\nHow youll help us make health happen:\nSupport the clinical team in holistic care and update documentation\nConduct audits and lead service improvements\nAnalyse claims to manage and reduce expenditure\nProvide clinical advice to claims teams\nCollaborate on claims review and benefits policy\nProvide monthly data analysis to stakeholders\nImplement standardized care management guidelines\nAudit healthcare providers records and billing\nInvestigate health insurance misuse\nDocument decisions and processes confidentially\nPrepare audit reports and follow up on recovery\nUnderstand claims cycle and provider behaviour\nStay informed on legal auditing requirements\nIdentify improper billing practices\nSupport data quality and service encoding\nUphold department goals and values\nCollaborate on provider audit processes\nKey Skills / Qualifications needed for this role:\nA degree in medicine or equivalent with 5 years clinical and 3 years insurance industry experience especially in audit\nExperience in international private medical insurance or hospital administration\nStrong numerical skills and ability to produce financial reconciliations\nUnderstanding of private hospital industry pricing and quality dynamics\nProven track record of achieving targets with high quality\nThe ability to liaise with various teams and management levels; good team player\nAdaptable to new skills changing practices and environments\nEmpathetic towards customers while maintaining professionalism\nExcellent communication skills\nThe ability to work under pressure and independently.\nConfident with good influencing and appropriate challenging skills\nOrganises work effectively and works independently\nWhy Bupa\nWere a health insurer and provider. With no shareholders our customers are our focus. Our people are all driven by the same purpose helping people live longer healthier happier lives and making a better world. We make health happen by being brave caring and responsible in everything we do.\nWe encourage all of our people to Be you at Bupa we champion diversity and we understand the importance of our people representing the communities and customers we serve. Thats why we especially encourage applications from people with diverse backgrounds and experiences.\nBupa is a Level 2 Disability Confident Employer. This means we aim to offer an interview/assessment to every disabled applicant who meets the minimum criteria for the role. Well make sure you are treated fairly and offer reasonable adjustments as part of our recruitment process to anyone that needs them.\nIf you require information regarding this role in an alternative format please email: \nTime Type:\nFull timeJob Area:\nDelivery and OperationsLocations:\nEgypt - Cairo","description_format":"text","description_chars":3896,"description_truncated":false,"requirements":{"experience_years_min":null,"management_years_min":null,"team_size_min":null,"manages_managers":false,"education":null,"security_clearance":false,"languages":[]},"benefits":["Health insurance"],"hiring_locations":[{"name":"Egypt","iso":"EG","kind":"country"}],"hiring_excludes":[],"relocation_offered":false,"industries":["Hospitals & Health Systems","Nursing Homes & Long-Term Care","Health Insurance & Benefits"],"lifecycle":[{"event":"open","at":"2026-11-12T00:52:55Z"}],"visa":[],"liveness":{"score":90,"band":"hot","label":"Hiring now","p_open":1,"p_active":0.903,"p_room":1,"age_days":2,"expected_fill_days":58,"reasons":["seen:2","velocity","win:early"],"computed_at":"2026-11-12T10:38:37Z"},"pay":null,"html_url":"https://alion.io/job/bupa-claims-clinical-auditor","json_url":"https://alion.io/job/bupa-claims-clinical-auditor.json","meta":{"generated_at":"2026-11-13T19:31:55Z","cache_seconds":300,"methodology":"https://alion.io/methodology","terms":"https://alion.io/terms","contact":"https://alion.io/contact","api":"https://alion.io/developers","about":"Alion is a live layer of people, companies and AI agents: who they are, whether they are real and active right now, what they do and how to work with them, readable by people and by agents and paid per call.","catalog":"https://alion.io/catalog.json","usage":{"tier":"crawler_verified","counted_by":"address","units_charged":1,"used_today":38939,"day_limit":null,"remaining_today":null,"minute_limit":300,"resets_at":"2026-11-14T00:00:00Z"}},"offers":[{"id":"company.slices","title":"One company in depth, by slice","status":"live","price":{"credits":0.1,"usd":0.01,"plus_per_slice":{"credits":0.05,"usd":0.005}},"unit":"per company, plus each slice with data","note":"the employer in depth","call":{"mcp_tool":"get_company","arguments":{"id":973},"rest":"https://alion.io/mcp/rest/get_company?id=973"},"human":"https://alion.io/catalog?offer=company.slices&for=job%2Fbupa-claims-clinical-auditor"},{"id":"market.stats","title":"A market slice: pay, demand and time to fill","status":"free","price":{"credits":0,"usd":0},"unit":"per slice","note":"pay, demand and time to fill for this role and place","call":{"mcp_tool":"market_stats"},"human":"https://alion.io/catalog?offer=market.stats&for=job%2Fbupa-claims-clinical-auditor"},{"id":"job.search","title":"Open jobs by role, technology, place, pay and visa","status":"live","price":{"credits":0.1,"usd":0.01},"unit":"per posting in a list","note":"similar open postings","call":{"mcp_tool":"search_jobs"},"human":"https://alion.io/catalog?offer=job.search&for=job%2Fbupa-claims-clinical-auditor"},{"id":"company.verify","title":"Is this company real and active right now","status":"pilot","price":null,"unit":"per company","request":{"url":"https://alion.io/catalog/request","method":"POST","body":"{\"offer\": \"company.verify\", \"for\": \"job/bupa-claims-clinical-auditor\", \"note\": \"what you need it for\"}"},"human":"https://alion.io/catalog?offer=company.verify&for=job%2Fbupa-claims-clinical-auditor"}],"agent":{"mcp":"https://alion.io/mcp/jobs","mcp_open":"https://alion.io/mcp/open","next":[{"tool":"get_job","arguments":{"id":4123442}},{"tool":"search_jobs","arguments":{"company":"bupa.com","detail":"compact"}},{"tool":"match_people","arguments":{"job_id":4123442},"note":"people open to offers who fit this vacancy"}],"note":"The same data through MCP tools: https://alion.io/mcp/open needs no sign-in (compact searches, postings, people); https://alion.io/mcp with an Alion account has everything. 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