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To obtain for inpatient and outpatient cases for all insurance patients.
Responsible for Participation in interdepartmental teams to identify operational requirement, problem solve and develop process for care contracts.
Responsible for daily following of approvals of the companies’ patients.
Responsible for Fulfilling all medical reports for out-patients & in-patients if needed
Responsible for Following the utilization and services requested for co. patients and discussing with all attending doctors
Responsible for getting approvals for medically justified and covered investigations as per policy and special approval such as C.T & physiotherapy for prior approval and evaluating the cases that doesn’t need approval
Responsible for Insuring timely response to inquiries concerning authorization issues
Responsible for Preparing monthly companies reconciliation
Responsible for supervising the performance of the outpatient department with company patients.
Responsible for Representing the NEOM Hospital in external and internal business that assigned to him / her to be done within the scope of the department and NEOM Hospital policies.
Calculate and issue invoices for cash patients and discharge the patients.
Check the approval for company / insurance patients.
Calculate and issue invoices for services not covered by the respective company / insurance.
Prepare company / insurance invoices.
Prepare the daily Discharge Summary Reports.
Prepare the daily and monthly statement of all external doctors.
Prepare estimation of patient invoices for insurance with maximum limit and cash patient.
Prepare the daily Discharge Summary Reports.
Apply PKD if any, Apply Room Difference if any.
Apply itemized services if any.
Identifying the provided services either (included / excluded) from PKGs.
Allocating provided services accordingly, Applying the discounts accordingly, save the performed actions, Invoice generation.
Provide patient with admission & discharge policy, time of admission and room selection
Verify patients’ identification and financial benefit to determine admission eligibility
Greet the patient, enter the demographic information, insurance information and obtain the signature on the legal consent & forms
Prepare admission file with all necessary hospital paper like, consent and policies before the scheduled appointments
Maintaining the log note for VIP suites reservation request
Follow up with patients who are willing to postpone their admission and inform them to reschedule the admission date
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.
OTHER SKILLS AND ABILITIES :
Able to recognize and accept ownership and propose solutions.
Tackles problems in professional manner and develops measures to prevent problems
Excellent Communication Skills
Must be able to clearly communicate with health plans, physicians and vendors.
Must be detailed oriented.
JOB REQUIREMENTS / QUALIFICATIONS :
Education:
Bachelor Degree in Business Management or related field
Experience:
0 – 2 years’ experience in related field or insurance companies