| Job Location | Jeddah , Saudi Arabia |
| Education | Not Mentioned |
| Salary | Not Mentioned |
| Industry | Medical Clinic |
| Functional Area | Not Mentioned |
1) Verify the eligibility of patients insurance and the extent of its coverage within the complex2) Update the insurance policy information in the system database.3) Review the contract policies set in the system.4) Explanation of medical benefits coverage for patients as per the agreed policy when required.5) Assist patients, reception staff, customer service and patient affairs in solving any medical insurance issue.6) Assisting in preparing and submitting claims and cooperating with clinic nurses in reviewing and completing papers.7) It secures pre-approvals and completes the following processes:? Receiving pre-approval requests from the treating physician? Review the patients scanned cards if they are valid.? Reviewing the services and codes used and ensuring that all the necessary information is justified before processing the request to the corresponding insurance company.? Communicate with the attending physician if additional information is needed.? Complete pre-authorization requests for any technical issue as per the motivation feedback (eg attach patient result as needed)8) Verify the patients file data and a copy of the attached insurance card and ID9) Correctly communicate with the attending physician for any refusal or rejection.10) Identifies issues related to pre-authorization and reports correctly and accurately and presents them to the Insurance Manager.11) Carry out the duties assigned to him by the Insurance Manager.12) Maintain confidentiality at all times.13) Adherence to the policies and protocols of the insurance management and according to the policies of the Health Insurance Council and insurance companies
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