Overview
Medical Approval Coordinator Jobs in Riyadh, Saudi Arabia at National Medical Care Company
Obtain medical approvals from third-party insurance companies through proper communication and documentation in a timely manner before rendering services to the patients.
Major Duties and Responsibilities
Ensures through his actions, either directly or indirectly, that a superior quality of medical treatment, compassion and understanding is given to every patient served at the CARE Hospitals and Clinics.
Send approval requests through insurance portals or insurance fax system.
Answer queries regarding approval requests and update patients about approval request status.
Send SMS to the patient regarding approval status.
Coordinate with physicians to get further information or report if requested by insurance companies.
Update approval status in Hospital HIS system such as send, waiting, approved, rejected.
Update HIS with details about rejection or partially approved requests.
Enter approved cost, Length of stay approved, partial approvals or rejected items in HIS system with detailed notes for admitted patients.
Inform case manager, approval manager and admission manager regarding immediate stoppage of patient coverage during inpatient stay.
Communicate with Rowing insurance doctors and update inpatient approval status.
Confirm approved services, with real invoice after service to make sure adequate approval is obtained.
Eradicate pending approvals after requested from physicians and report unattended approvals to approval manager.
Prepare daily report for all approval activities.
The claim document should be handed over to business center department on a daily basis.
Refer all inquiries for preparing response for the financial rejections done by the contracted companies to Head of Rejection Management.
Ensure proper flow of documents supporting the changes and report the shortcomings to the concerned.
Review all contracts from the financial point of view prior to accreditation from the administration.
Correlation between Finance, Patient Services, Pharmacy and other concerned departments offering the service about application of the terms of contracts and documents.
Perform additional tasks and duties as assigned by Superiors.
Reporting to
Approval manager
Qualifications:
Education
High school certificate
Diploma in any medical/accounting course highly preferred
A minimum of:
Two (2) years’ experience in Approval field
Good communication skills in English and Arabic language.
Computer literate (MS Office)
Familiar with medical terminology.
Customer service experience and education courses.
Must have tact, courtesy and public relation skills.
Seniority level
Associate
Employment type
Full-time
Job function
Health Care Provider and Other
Industries
Hospitals and Health Care, Insurance, and Medical Practices
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Title: Medical Approval Coordinator
Company: National Medical Care Company
Location: Riyadh, Saudi Arabia
Category: Healthcare
