Hybrid Private Medical Claims Auditor

Marsh McLennan; Greater London; Hybrid; GBP 60,000 - 90,000; Full time

Benefits offered by this job

Hybrid working

Office three days per week

Job summary

Mercer is seeking a Private Medical Plan Auditor to join our Workplace Health team in London. This hybrid role requires three days per week in the office and focuses on independent oversight of Private Medical Trusts' claims processing by the TPA.

You will audit claim setup, adjudication, and payments, identify over-/under-payments and coding errors, and produce client-ready reports with actionable recommendations. Data privacy compliance is essential.

Qualifications

• Solid experience in PMI claims operations with TPA/insurer exposure.
• Strong knowledge of PMI benefits and scheme rules.
• Excellent attention to detail.
• Proficient in Microsoft tools and data analysis.

Responsibilities

• Audit delivery and claims quality across types with risk-based reports.
• Validate post-payment TPA decisions and payments.
• Produce client-ready audit reports with findings and trends.
• Ensure data privacy and confidentiality in handling health data.

Skills

PMI claims operations

Audit reporting

Data privacy

Microsoft tools

Project coordination

Stakeholder management

Education

PMI claims qualifications (local equivalent)

Tools

Microsoft Office Suite

TPA/Claims systems

Job description

Mercer is seeking a Private Medical Plan Auditor to join our Workplace Health team in London. This hybrid role requires three days per week in the office and focuses on independent oversight of Private Medical Trusts' claims processing by the TPA.

You will audit claim setup, adjudication, and payments, identify over-/under-payments and coding errors, and produce client-ready reports with actionable recommendations. Data privacy compliance is essential.