The Insurance Administrator is responsible for ensuring the smooth flow of the Department’s daily activities with a primary focus on pre-approvals. The Insurance Administrator liaises with Insurance Coordinators, Clinics/Doctors (CBS & In-House), and patients regarding pre-approval related information and/or documentation.
* Relevant tertiary diploma or degree
* Qualification in a medical-related course is an advantage but not required
* Medical insurance background, preferably in a healthcare industry.
* Experience working with / liaising with local insurance companies
* Knowledge of medical terminology will be an advantage
* Above average computer literacy and a good working knowledge of Microsoft Office.
* Above average verbal and written communication skills.
* Coding experience is a must
* Ability to analyze statistical data
* Fluency in English is required and Arabic language skills will be well regarded
* Proficiency in MS Office applications.
* Experience working in a similar position
* Ability to perform tasks completely and accurately within set time frames
* Ability to work independently within set guidelines.
* Experience in providing good customer service
* Good attention to detail
* Prepare cost estimates for various out-patient and in-patient cases.
* Assist the Insurance Coordinator to source insurance approvals
* Contact Insurance Companies for verbal approvals as required
* Review the In-Patient list and the Operating Theatre list to ensure an understanding of current approval statuses
* Review and distribute the pre-approvals to concerned departments in a timely manner
* Identify unusual denials and medical report requests and contact the Insurance Companies for clarification and resolution
* Provide expert advice on various insurance policies and coverage to external and internal clients
* Communicate effectively between doctors and Insurance Companies when further information is required
* Maintain and update the approval log
* Review pending cases and follows up on these to ensure swift resolution
* Coordinate with external and internal clients for approval-related information
*Distribute insurance related updates to all relevant areas of the Hospital
*Update the Insurance Manager about any unusual denials/issues from Insurance Companies and provide recommendations for resolution
*Assist the insurance Manager to manage reconciliation related issues
*Establish and maintain the approval files for easy access for the Dispatch and Resubmission team
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