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Job Description
- Respond to external and internal telephone calls in the assigned area and ensure that they are answered in a professional and timely manner in accordance with department policies, procedures and performance goals to handle the cases and solve any problems.
- Maintain the current contracted providers in the assigned area by making communication with and receive requests from the providers. Solve the problems facing the medical providers during dealing with AMC.
- Discuss the deductions applied on the providers with them, study the reasons of every deduction and tries to avoid it in the future, while solving the current deduction issues.
- Receive inquiries about bills from providers to release this payment as soon as possible by communicating with the concerned departments and informing the supervisor (track the payment in case of delayed to conduct fast tracking with other departments).
- Prepare detailed analysis of the assigned geographical area to determine the weakness points and defects in this area which needs to be fixed by adding new recommended providers.
- Start communication with new providers in assigned area either by requests received from our clients or according to the business need to add new providers based on network area analysis.
- Ensure that contracting processes are done through preparing all the contracts after negotiation with the providers about prices and discussing with the provider AMC operation procedures to be fully aware about it before contracting. Get the approval of contracting from AMC Management and from the provider with required legal documents.
- Send claim forms to providers in the assigned area to ensure that all the providers in this area have enough claim forms.
- Deliver the contracts after finalizing the required process to the Price Building Coordinator.
- Coordinate with other departments as Claims, Batch Receiving, and Finance to finalize all the pending batches due to lack of some documents after returning batch to the provider
- Conduct visits to the providers based on the business need to follow-up with the contracted providers or to finalize contracts with prospective providers.
- Conduct on job training to the new staff to transfer the knowledge to them to be aware with the department’s procedures and work nature
Job Requirements
- BSc Medicine or Pharmacy or any other related studies.
- 2-4 Years of Experience.
- Good Command of MS Office .
- Excellent in English .
