Dallah Hospital
Health Insurance Clerk jobs in Saudi Arabia
KEY RESPONSIBILITIES:
1. Enter the UCAF information in HMIS.
2. Follow up all pending approval request for in-patient & out-patient and assure that company approval is granted for all services.
3. Contact companies who have contracts with the hospital with relation to referral and approval of treatment.
4. Provides information to patient concerning covered services and approval requirements under their company health plan.
5. Assure that all inpatient hospitalized within the approval limit.
6. Fully aware and actively implement the departmental policies and procedures, local and international standards or requirements related to the department
7. Actively involves in indicator development, data collection for the department and to measure the performance of the function, process, and outcome. Whenever required, conducts analysis and interpretation of data/information collected.
8. Participate in hospital Safety Management & Risk Management Programs. Actively reports incidents in the system and whenever needed, participates in incident review, and root cause analysis.
9. Performs any other duties within the range of his/her competence, as directed by Head of Medical Insurance and/or the Revenue Cycle Director.
10. Administrative activities of the department are run by the health insurance clerks.
Necessary Knowledge and Experience:
Minimum of two years post-qualification experience, to include contract management Experience in a Health Care setting.
Education and Certification Requirements:
Bachelor in Accountancy / Commerce Management or any related course.