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