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American Hospital
Medical Advisor Jobs in Dubai, UAE
JOB DESCRIPTION
Oversees both internal and external insurance administration, including data collection and administration. Liaises with insurers and internal stakeholders to coordinate billing arrangements and ensures adherence to agreed formalities with insurance companies, minimizing objections and delays. Coordinates with various personnel such as Patient Relations, Nursing, Physicians, and Finance, and ensures prior authorizations for outpatient and inpatient services are monitored and followed up on. Analyses claims before submission, reconciles paid and outstanding claims, prioritises accurate and thorough work, anticipates departmental needs, resolves problems with sound judgment, and supports hospital and departmental policies and procedures.
RESPONSIBILITIES
- Monitors and follows up on securing prior authorization for all Inpatient (IP) services and outpatient services based on the insurance contractual agreements.
- Finalizes approvals and reviews bills before claim submission to the billing/submission team and coordinates for correction of errors.
- Liaises with insurers and internal stakeholders to coordinate billing arrangements and insurance administration.
- Oversees the administration and data collection of internal and external insurance administration.
- Coordinates with the following appropriate personnel to ensure that all the formalities are fulfilled based on the agreement with the insurance Companies to minimize rejections/denials:
- Patient Relations
- Nursing
- Physicians
- Finance
- Reconciles claims paid and outstanding with insurance companies in coordination with the resubmission/reconciliation team.
- Makes accurate, thorough, and appropriate work a priority.
- Anticipates and sets priorities to support department needs and follows policies and procedures.
- Identifies and analyses problems, takes action to resolve them, applies sound judgement and takes responsibility for their resolution.
- Supports the Hospital and Departmental Policies and Procedures.
QUALIFICATIONS
- Bachelor’s Degree in any field, Medical preferred
- Certificate in Hospital Management preferred
PROFESSIONAL EXPERIENCE:
- Minimum of three (3) to five (5) years of experience in a similar field.
- Knowledge of Hospital Operations and Insurance processes.
- Skills in Microsoft Office (e.g. Excel, Word, PowerPoint, Outlook, etc.).
- Skills in leadership, relationship management, analysis, and organisation.
- Ability to write and speak in English fluently.
- Ability to negotiate and influence stakeholders.
To apply for this job please visit fa-epvs-saasfaprod1.fa.ocs.oraclecloud.com.
