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Ping An Insurance Group · 南昌市

# 医疗稽核岗-南昌

南昌市 

Listed on Ping An Insurance Group’s official careers site. Posted April 9, 2021. Check that it is still open and apply there.
[Apply on Ping An Insurance Group’s careers site →](https://talent.pingan.com/recruit/position.html?positionId=717615AD44C74EF8896B29C1BDCFCC4F)

[OpenNash Jobs](https://jobs.opennash.com/) / [Ping An Insurance Group](https://jobs.opennash.com/companies/ping-an-insurance/) / 医疗稽核岗-南昌

## Job description

岗位职责
- 走访医疗机构，对医疗机构的医疗仪器使用、财务流水凭证、药剂试剂耗材等情况进行抽查，针对异常情况收集证据，完成相关报告或建议书。
- 通过提取医院HIS数据及医保核心系统数据，对医院结算表、药品耗材进销存表、患者就医信息表等表格中的相关字段数据进行分析，对异常或疑点数据进行统计汇总，为线下稽核方向及要点的制定提供数据支持。
- 审核稽核病历，根据数据分析情况，抽调定点医疗机构、定点零售药店的病历、处方、销售数据、结算票据等纸质稽核材料进行审核，对病历中诊疗、用药等医疗行为的合理性及一致性进行判断，对发现的可疑或违规行为进行进一步调查核实，
- 根据公司安排落实飞行检查工作，并完成相关报告反馈总部及政府相关部门，
- 完成领导交办的其他工作。 任职资格
- 全日制本科及以上学历，医学相关专业及IT、数据分析专业背景优先。
- 有医保、医院、医疗信息等工作经验优先；特别是医院稽核工作经验或审核风控经验。
- 有临床医学经验，熟悉医保政策及医保理算规则，对医疗行为有较强的敏感度。
- 逻辑推断能力强，抗压力强。

## At a glance
- Posted by the employer: Apr 9, 2021
- First seen by OpenNash: Oct 20, 2026
- Last checked: Oct 20, 2026
- Listed for: Over a year
- Location: 南昌市[Apply on Ping An Insurance Group’s careers site →](https://talent.pingan.com/recruit/position.html?positionId=717615AD44C74EF8896B29C1BDCFCC4F)

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### [企康客户经理岗](https://jobs.opennash.com/companies/ping-an-insurance/jobs/829c4159e662f7d941ff/)

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