Senior Medical Claims & Approvals-Private Hospitals Background

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New Cairo, CairoPosted 1 year ago

184Applicants for2 open positions

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Examine claims records and forms to determine whether the patient has medical insurance.
Review provisions of certificate or policy to determine the patient’s included medical coverage losses.
Negotiate claim settlements and make recommendations for settlements.
Complete logs, reports, forms and records to properly document medical claims.
Reject or accept documentation, determine benefit due, and start the denial or payment process to resolve medical claims.
Adhere to all company policies, procedures and guidelines in addition to insurance regulations at Hospital.
Examine medical treatment records, reports and medical bills to gauge overall extent of liability.
Interview and communicate with claimants, physicians and other necessary individuals to decide claim denial, settlement or review.
Ensure all claims information remains confidential.
Resolving customer complaints by investigating issues and recommending solutions
Preparing reports on claims status and other details about policyholders’ accounts, including payment histories and outstanding balances.
Perform periodical monthly dash boards.

Medical Educational Background- preferably physician.

Hands on experience in handling Medical Claims, Approvals and revenue cycle management at private hospitals.

Strong communication skills.

Agile leadership skills

Very good English