Auditor Doctor

Our client is seeking an experienced and highly skilled Auditor Doctor to join its Travel Medical Assistance team.

This role is responsible for the clinical review, validation, and auditing of medical assistance cases worldwide. The selected candidate will ensure that all medical decisions, treatments, and costs are clinically justified, evidence-based, and aligned with insurance policy coverage and international medical standards.

The role is central to ensuring patient safety, quality of care, and effective cost control across global medical cases, while supporting operational teams in real time.

Key Responsibilities

Medical Review & Case Regulation

• Review and medically validate travel medical assistance cases, including outpatient care, hospitalisations, surgeries, evacuation, and repatriation.
• Assess medical necessity, appropriateness of care, length of stay, and treatment plans.
• Provide second opinions and medical recommendations to assistance coordinators and case managers.
• Identify cases requiring escalation to the Medical Director.

Cost Containment & Compliance

• Ensure treatments and services align with medical best practices, internal guidelines, and insurer policies.
• Evaluate high-cost cases and propose cost-effective alternatives without compromising patient safety.
• Validate medical invoices and support billing audits by confirming clinical justification of services rendered.
• Detect potential over-treatment, non-covered services, or billing inconsistencies.

Coordination & Stakeholder Collaboration

• Liaise with international hospitals, clinics, treating physicians, and medical providers.
• Work closely with assistance operations, claims, legal, and network management teams.
• Provide medical input during negotiations with providers when required.

Medical Governance & Quality Assurance

• Contribute to the development and updating of medical protocols, clinical pathways, and audit criteria.
• Participate in clinical audits, peer reviews, and quality improvement initiatives.
• Ensure compliance with ethical standards, medical regulations, and data protection requirements (e.g. GDPR).

Reporting & Documentation

• Maintain clear and accurate medical documentation and audit notes.
• Produce regular reports on case trends, cost drivers, and medical risk indicators.
• Support internal and external audits with structured medical analyses.

Requirements

• Medical Degree (MD or equivalent) from an accredited institution.
• Valid medical license (active or eligible depending on jurisdiction).
• 5–10 years of clinical experience.
• Strong clinical judgment and analytical skills.
• Solid understanding of international healthcare systems.
• Ability to balance medical quality and cost efficiency.
• Excellent communication skills (written and verbal).
• High level of autonomy and decision-making ability.
• Ability to work under pressure in time-critical situations.
• Fluency in English is required.

Desirable Skills

• Postgraduate training or experience in Emergency Medicine, Internal Medicine, General Practice, Anaesthesiology, Critical Care, or Travel/Tropical Medicine.
• Experience in medical assistance, travel insurance, insurance medicine, or medical auditing.
• Experience in international healthcare coordination.
• Additional language skills will be considered an asset.

Working Conditions

• Office-based or hybrid role with limited or no direct patient contact.
• Flexibility required for on-call availability for complex or high-risk cases.
• Collaboration across multiple time zones.

What’s on Offer

• Strategic medical role with global exposure.
• Competitive remuneration package.
• Opportunity to influence international medical standards and patient outcomes.
• Professional development in medical governance and insurance medicine.