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Job Description
General Description
- The Case Management specialist is responsible for procedure revision & documentation at the OR and Critical care units to ensures quality and appropriate service delivery.
Responsibilities:
- Track, monitor & record all procedures &/or processes that the patient is getting to ensure the right documentation.
- Follow up with the insurance company &/or credit cash clients on approvals, submissions & denials.
- Presents a periodic report to concerned parties to include but not limited to the daily events at the OR/Critical care units, consumption, denial record, and submission records …etc.
- Ensure what is been approved for the patient by their insurer has been implemented.
- Ensure the timely & accurate submission of requests to the insurer.
- Replying any medical inquires the patient needs concerning the presented medical service inside the hospital.
Job Requirements
Qualifications:
- Bachelor's degree in medical science is a must (Bachelor of Medicine & surgery) is Preferred.
- Healthcare & hospital management diploma holder or equivalent.
- Minimum 2 years' experience in Insurance company
- Has an experience with ERP systems as a user.
- Advanced knowledge Microsoft office, with a special focus on Excel & power point.
- Excellent command of written and spoken English essential
Skills:
- Analytical thinker
- Arithmetic thinking
- Attention to details
- Solving problems
- Collaboration & Teamwork
- Communication Skills
