Job Details
Skills And Tools:
Job Description
Job Purpose;
Ensure best medical service with efficient price
control to retain the patients. Coordinate and direct the preparation of the OR procedure with financial forecasts and report variances. Ensure best patient journey inside the hospital by ensuring best communications among Approvals, admission office, OR, finance and RCM. Follow up, as needed, on all inquiries to ensure both patient and treating physician’s satisfaction, and corporate expectations being met.
Core Responsibilities
Pricing of all OR procedure giving the best price.
Ensuring the Admission\OR procedure Cycle closure with best
performance.
Coordination of all ceiling limited approvals to ensure doing
the procedure in the hospital\Group.
Responsible for Interviewing and training of the new
employees on surgical procedure and expected cost handling prior to the
admission.
Daily operation monitoring done by Approval team
Set Goals;
Daily medical update on cases for inpatient cases.
Daily financial situation updates for inpatient cases.
Acts as a liaison with OPC coordinators, approval team,
admission office, and insurance case managers prior to admission till
discharge.
Provide program information via e-mail or phone to insurance
companies and patients
Utilize time efficiently to explain and assist with insurance
issues.
Collect and maintain appropriate records and statistics
related to approvals
Job Requirements
Education:
Bachelor of Medicine and Bachelor of Surgery “MBBS”.
Experience and Skills:
3-5 years of experience as Insurance doctor “Approval\Claims”.
Good command of English.
Excellent communication skills.
Knowledge of and proficient in computer programs: MS Office, Outlook, Database, Document Imaging, etc.
Able to lead others in high-demand situations.
Coaching, guiding, or tacking.
Delegating tasks or responsibilities.
Evaluating performance, programs, processes, or events.
Work effectively to achieve both individual and department goals and objectives.
Strive consistently to promote a positive team spirit.
Contribute to the team positively.
Budget Development.
