JOB SUMMARY

The Officer - Insurance ensures the efficient and smooth processing of patient insurance claims and recovery through effective liaising with insurance companies while maximizing patient satisfaction. Responsible for timely insurance claim pre-authorization processing and training NMH staff on insurance protocols.

DUTIES & RESPONSIBILITIES

1.   Monitors the daily admission and discharge process for obtaining a list of admitted patients for authorizations prior to discharge

2.   Liaises with treating physicians to receive properly completed claim form requests for services which require approvals as per policy terms and conditions

3.   Communicates to patients regarding their insurance policies, eligibility and entitlements

4.   Liaises with insurance companies, forwarding medical histories or data to support pre-approval requests

5.   Coordinates with colleagues and other related departments for smooth running of insurance operations

6.   Controls the uncovered medicines in the system to avoid rejections (with IT assistance)

7.   Follows up with insurance companies to facilitate urgent approvals required and reports critical issues to Insurance Manager

8.   Liaises with insurance companies to minimize response time for approval and advises patients about rejections

9.   Segregates authorizations received and forwards to concerned departments

10. Educates reception, nursing and paramedical staff on insurance protocols, new processes or modifications as notified by insurance companies from time to time

11. Receives letter of guarantees from international payers and forwards to concerned departments

12. Participates in weekly departmental meetings for updates and new processes

13.   Enhances professional growth of self through participation in training programs, current literature and in service meetings

14.   Attends meetings as required.

15.   Performs other related duties as assigned by the Manager- Insurance.

Skills

JOB REQUIREMENTS

EDUCATION: Bachelor’s degree in finance or a related discipline.

EXPERIENCE: Preferably 5 years’ experience in the field of insurance with at least 3 years in Healthcare

PERSONAL ATTRIBUTES :

Technical: Familiar with medical terminology. Good typing speed.

Administrative Skills: Negotiation, Problem Solving and Organizational skills; Attention to Detail; Flair in Managing Files and Records, Designing Forms, and other Office procedures

Soft Skills: Good Communication and Inter-Personal skills

Computer Skills: MS Office (Word, Excel, Power Point, Outlook) and Typing in English & Arabic

Language Skills: Good in written and spoken English and Arabic