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Approval Physician

JOB Type
Requisition ID

Duties and Responsibilities:

  • Researches and analyzes denial data and coordinate denial recovery responsibilities.
  • Identifies, analyzes, and researches frequent root causes of denials and develops corrective action plans for resolution of denials
  • Develop reporting tools that effectively measure and monitor processes throughout the denials management process in order to support process improvement.
  • Uses reports that categorize denials to assign tasks or personally work to overturn denials Identifies and pursues opportunities for improvements in denial performance
  • Researches, responds, and documents insurer and patient correspondence/inquiry notes regarding coding coverage, benefits, and reimbursement on patient accounts
  • Makes management aware of any issues or changes in the billing system, insurance carriers, and/or networks Performs inpatient, ambulatory surgery, emergency room, outpatient and evaluation/management coding audits on the team members work
  • Responsible for providing billing compliance education to all physicians and advanced practice practitioners within the division
  • Provide feedback of audit findings to physicians and conduct post-audit training sessions as audit results Supervising and processing the In-Patient approvals
  • Ensuring that the correct current procedural terminology, or CPT, and international classification of disease, or ICD-9, codes are used
  • Demonstrates compassionate communication skills while providing support and care to the patients as “the patient is the center of our care”.

    Other Job Functions:

  • Perform all duties and tasks in line with the Person Centered Care values.
  • Adherence to all policies, plans and programs within the Fakeeh Care.
  • Perform duties as per the code of conduct requirement and ethical standards as outlined in the HCM policies and guidelines.
  • Complete mandatory education as per the requirement at least one month prior to expiration.
  • Maintain up to date knowledge on information relating to quality and safety, accreditation, policy management and document management systems.



    Bachelor degree in Surgery and Medicine


    Healthcare industry experience is preferred, relevant experience in insurance role is preferred


    Arabic & English

    Required Licenses:

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