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Insurance Manager

1.00 to 10.00 Years   Cairo, Egypt   16 Dec, 2021
Andalusia Careers
1 Jobs Openings
Job LocationCairo, Egypt
EducationNot Mentioned
SalaryNot Mentioned
IndustryMedical Hospital
Functional AreaNot Mentioned

Job Description

Summary:Leads the insurance function with the objective of streamlining the process of patient insurance claims and recovery through effective liaising with insurance companies while maximizing patient satisfaction.Responsibilities:Planning & Monitoring Process

  • Review insurance policies.
  • Analyze statistical data, such as mortality, accident, sickness, disability, and retirement rates and construct probability tables to forecast risk and liability for payment of future benefits
  • Identify and analyze risks associated with policies.
  • Reviews insurance claims to ensure accuracy as per agreement, prior to dispatch to respective insurance companies.
  • Monitors insurance discounts and rejections and prepares & submits periodic reports to the Finance Manager for review.
  • Ensures that the insurance schemes are up to date on the system.
  • Conducts weekly departmental meetings with staff for updates and to educate them on new work methods
  • Monitoring Claims quality per department to ensure claims verification according to insurance companies? policies.
Operational Excellence Process
  • Ensure his staff is meeting production goals, complying with the hospital standards and governmental collection laws and generally performing the essential functions of their position.
  • Supervise and coordinate activities of workers engaged in collecting overdue payments for charge accounts, credit card accounts, or loans from customers of banks, loan companies, department stores, oil companies, or other credit-card-issuing companies.
  • Manage operations and productivity at an insurance department.
  • Create and modify procedures and documents related to policies.
  • Assist in claims management.
  • Achieve target budgets.
  • Minimize risk of financial loss.
  • Obtain and oversee company insurance or related funds that management uses to cover costs such as disability benefits or lawsuits.
  • Direct information for claimants.
  • Preside over claims investigations.
  • Manage insurance data for reports.
  • Determine premium rates.
  • Ascertain cash reserves necessary to ensure payment of future benefits.
  • Oversees administration of medical services to Insurance and Corporate patients or/and customers of the Hospital.
  • Liaises with insurance companies regarding eligibility, payments, reconciliation and other requirements
  • Proactively reports critical issues to Management and submits monthly aging and other reports to line manager and Accounts.
  • Provide the necessary guidance and on-job coaching and in-service training for the staff under your direct supervision;
  • Align clinical protocol between insurance companies and hospital medical management to minimize claim rejection percent.
Innovation Process?
  • Designs, updates and implements policies, procedures and protocols to ensure efficiency and accuracy in insurance operations.

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