Precertification Officer

• Assesses approval of medical approvals as well as policy use
• Checks particular treatment plan is necessary for the patient.
• Inputs verbal and written claims approvals regularly.
• Decides approvals as per policy conditions.
• Assess high cost claims and provide decision on high cost and complicated cases.
• Provides clear feedback on queries from call Centre team.
• Provides clients an understanding of any declined medical claims.
• Coordinates work flow & meet deadlines.
• Evaluates claims with regards to eligibility.

Behavioral Requirements :

• Strong verbal and written communication skills.
• Show flexibility, excellent interpersonal skills.
• Team Player.
• Attention to detail and quality.
• Ability to work well with all levels of internal management and staff, as well as outside clients and users.  
• Ability to train other staff.
• The ability to communicate sensitively and effectively with claims department and other departments having regard for the strict need for confidentiality.
• Experience of working with senior managers and understanding the necessity to act in a pleasant and courteous manner and to be able to work effectively with others.
• The ability to exercise initiatives and be able to work flexibly under pressure and to tight deadlines.