Auditor Doctor

Job Description

On behalf of our client, an Operational Travel Assistance Firm in Malta, GRS Recruitment is currently seeking an Auditor Doctor. The Auditor Doctor will be responsible for the medical review, clinical validation, and cost control of travel-related medical assistance cases. This role ensures that medical decisions, treatments, hospitalizations, evacuations, and repatriations are clinically appropriate, evidence based, compliant with international standards, and aligned with policy coverage and contractual agreements. The position plays a critical role in patient safety, quality of care, and financial governance, while supporting operational teams managing cases worldwide. If you meet the criteria, please apply for this Malta based role. MAIN DUTIES AND RESPONSIBILITIES Medical Review & Case Regulation Review and medically validate travel medical assistance cases, including outpatient care, hospitalizations, 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 medical 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 CANDIDATE PROFILE Medical Degree (MD or equivalent) from an accredited institution Valid medical license (active or eligible, depending on jurisdiction) Minimum 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 written and verbal communication skills High level of autonomy and decision making capability Comfortable working in time critical, high pressure environments Fluency in English required Due to the high volume of applications, we receive at GRS Recruitment, only shortlisted candidates will be responded to. To apply for this position, please email your CV to Michelle Cooper, quoting the above job reference. GRS Recruitment

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