Job Description

To manage the IP Approval claims. The primary purpose of this job position is to assist in the day-to-d ay approvals functions mainly for Insured beneficiaries in accordance to the agreed submission conditions as in the Standard Provider Contract signed with payers and what suite the hospital operations.

1.1. Coordinates and networking between insurance companies regards approvals for both

Outpatient and Inpatient, eligibility, payments and other requirements.

1.2. Responsible for getting pre authorizations from insurance according to operation set standards.

1.3. Ensure accurate application of contractual prices and discounts, schedule of benefits, correct allocation of benefits, collection of deductibles, co-payment and observance of

policy limits.

1.4. Needs to co-ordinate between doctors, nursing team, ward for getting the claim forms.

1.5. Getting approvals for medical procedures and also expertise in taking pre-approval for

radiology, dental, obstetrics etc.,

1.6. Manage queries from doctors, insurance companies and insured members relating to

claims processing, evaluation and administration.

1.7. Deliver excellent customer service to insurance companies and insured members with a

view of achieving maximum satisfaction.

1.8. Perform other related duties as assigned.

Educational Requirements:

- Bachelor's Degree or Associated Degree related to medical field.

Required Experience:

- Minimum of 3-5 years' experience in Healthcare - Northern Emirates

- CPC or CCS certification will be considered as an advantage

- Have medical field experience and qualification

- Can handle the Insurance department Independently

- Must be aware about latest medical codes

Job Type: Full-time

Pay: AED7,000.00 - AED8,000.00 per month