Medical Insurance Manager

Confidential Company - Maadi, Cairo

142
Applicants for
1 open position
140
Seen
13
Shortlisted
101
Rejected
Experience Needed:
4 to 6 years
Career Level:
Manager
Job Type:
Full Time
Salary:
Confidential
Languages:
Arabic, English
Vacancies:
1 open position
About the Job

Job Briefing

  • Supervision and coordination of Approval Doctors on process of pre-approvals.
  • This role includes monitoring of pre-approval Turnaround time, analyzing processes between Approvals and medical providers to ensure that all cases are categorize on specified priority and to reply to each request on a given specification limit.

Job Description

  • Supervises on concurrent review of Inpatient cases by visiting these admitted patients
  • Analyse prior-approval requests, negotiate the cases with the medial providers, approve the cases when agreement is reached and enter the claims
  • Supervise In-patient claims (this supervision includes visits to the patients during their hospitalization Supervises on claims audit and validation of processed claims Communicate with Insured Members on their claims and on any request coming from an Insured Member
  • Develop pricing strategies, balancing firm objectives and customer satisfaction.
  • Identify, develop, and evaluate marketing strategy, based on knowledge of establishment objectives, market characteristics, and cost and markup factors.
  • Negotiate contracts with vendors and distributors to manage product distribution, establishing distribution networks and developing distribution strategies