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Pre-Authorization Officer

Company
Internal
LOCATION
Internal
JOB Type
Full-time
Requisition ID
2400003N

Duties and Responsibilities:

  • Receive requests from Healthcare providers (Hospitals, Laboratories, pharmacies…) and reply with approval decision (approved or rejected).
  • Participate in committees, work groups, and/or process improvement teams that improve patient satisfaction.
  • Review all medical approvals & claims.
  • Issuance of necessary medicines and medical approvals - surgeries - X-rays - tests that require it.
  • Facilitate the service for patient.
  • Arrange internally for marketing offers of all concerned department and agreement announcement internally.
  • Make sure that everybody in the department knows the agreement.
  • Arrange the transferred cases from other hospital under care of insurance companies.
  • Arrange with assistant Director, attending doctor and insurance companies for acceptance and get approval.
  • Assist patient to understand the approved and disapproved services and explain to them the company reply/answer.
  • Arrange with financial dept. for applying discount rates agreed with companies for uncovered services for which patient would like to pay cash.
  • Orientation and training the new staff about hospital rules and insurance policies.
  • Responsible for implementing the full automation program and to solve problems/issues.
  • Investigate complaints received from the patient and report the matter to head of the department.
  • Other duties as assigned within the scope of responsibility and requirements of the job.
  • 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.

JOB REQUIREMENTS / QUALIFICATIONS :

    Education:

    High School Diploma, Bachelor’s Degree would be an advantage

    Experience:

    At least 2 years’ experience in any related field

    Language:

    Good command of Arabic and English (verbal and written).

    Required Licenses:

    N/A
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