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Medical Insurance Approvals Supervisor
Al-Hayat National Hospital - Abha
Job description
The Medical Insurance Approvals Supervisor is responsible for overseeing the medical approval process and ensuring efficient operations in accordance with health insurance policies. He also evaluates medical service approval requests and coordinates between hospitals and insurance companies to ensure appropriate healthcare is provided to patients.
Job requirements
- Education:
- Bachelor's degree in medicine, pharmacy, nursing, or healthcare administration.
- Experience:
- At least 3 years of hospital experience in the field of medical insurance and approvals.
- Skills:
- Comprehensive knowledge of health insurance policies and medical approval procedures.
- Ability to evaluate medical cases and make approval or denial decisions based on medical criteria.
- Strong communication and negotiation skills with healthcare providers and insurance companies.
- Proficient in the use of medical insurance systems and electronic medical records.
- Analytical skills and accuracy in reviewing medical applications and approvals.
- Tasks and responsibilities:
- Oversee medical approval processes to ensure compliance with approved policies and procedures.
- Review health insurance applications and ensure they meet requirements and standards.
- Coordinate with physicians and medical teams to ensure appropriate services are provided to insured persons.
- Communicate with insurance companies to follow up on medical approval cases and resolve disputes.
- Ensure prompt response to approval requests and reduce patient wait times.
- Provide periodic reports on the performance of medical approval processes and operational observations.
- Train and mentor employees to improve workflow efficiency.
- Languages:
Arabic
English