Associate, Claims Operations

Associate, Claims Operations Ever wondered who makes sure healthcare claims are accurate, fair, and free from fraud? That’s the role we’re hiring for. About Reliance Health We're a healthcare technology company of 400+ people using technology to make healthcare affordable, accessible, and delightful in emerging markets. We operate across Nigeria, Egypt, Senegal, and Côte d'Ivoire, with 300,000 people depending on us for their healthcare. We're one of Time Magazine's World's Top Healthtech Companies (2025). We're a data-driven team that values ambitious thinking, simple communication, and working without micromanagement. We move fast, learn by doing, and our diverse team spans multiple nationalities and backgrounds. The Role As an Associate, Claims Operations, you’ll play a key role in ensuring healthcare claims are processed accurately and efficiently. You’ll help maintain fairness in the system by validating claims, identifying inconsistencies, and supporting timely reimbursements. If you’re detail-oriented and enjoy applying clinical knowledge to solve real-world problems, this role is for you. What You’ll Do Review, validate, and process healthcare claims in line with company policies Ensure claims are accurately recorded and maintained in the system Investigate complex claims and make decisions based on clinical standards and internal guidelines Support timely payment of approved claims within defined service timelines Identify and decline fraudulent or suspicious claims Investigate cases of fraud, waste, and abuse, and escalate findings where necessary Collaborate with provider management teams to resolve provider-related issues Share claims updates and reconciliation details with healthcare providers Provide clinical input on complex care approvals when required Support patient referral decisions in collaboration with the care team What You’ll Bring Bachelor’s degree in Medicine (MBBS or equivalent) Minimum of 1 year clinical experience as a medical doctor Strong understanding of clinical procedures, terminology, and standards of care Ability to apply clinical knowledge to claims review and decision-making Strong numerical and analytical skills Experience working with data and processing information accurately Clear written and verbal communication skills Proficiency in Microsoft Word and PowerPoint Nice to Have Experience in claims processing or care approvals What We Offer Salary: EGP 16,518.19 monthly Hybrid role based in Cairo, Egypt Unlimited leave – take the time you need Premium health insurance for you and your family Learning and development allowance to support your growth Ready to Join Us? If this sounds like you, we’d love to hear from you. Apply today.