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Job Description
- Receiving all the requests, checking all the cases and its medical condition, and validate any procedures, treatments, and doses prescribed.
- Checking the eligibility of the cases regarding the contracts between Smart and the accounts as well as utilization of the patient.
- Respond to all requests by approval or rejection by phone, mail or fax.
- Make sure that all medical requests are handled according to the service level of the agreement either through acceptance or rejection.
- Attend and reply e-mails/telephones inquiries for pre-approvals and justification for rejected or partially approved cases.
- Adhere to Smart mission statement, core values, and company policies and customer service standards
Job Requirements
- Bachelor's degree in Pharmacy or Medicine .
- Minimum 6 months of experience in medical insurance
