Locum Approvals - IP and OP

• Bachelor’s Degree in any field, Medical preferred

PROFESSIONAL EXPERIENCE:

• Minimum of three (3) years of experience in a similar field
• Excellent English verbal and written communication skills
• Computer literacy is essential
• Very good understanding of hospital operations
• Intermediate to Advanced Microsoft Office
• Strong leadership experience
• Excellent relationship management
• Organised and thorough
• Excellent analytical and organisation

• Coordinates with stakeholders to ensure that all the formalities as agreed with the insurance companies are followed to minimize objections from them and delays in clarifications to the insurance companies:
  • Patient Relations
  • Nursing
  • Physicians
  • Finance
• Monitors and follows up on prior authorization for outpatient services wherever required and all Inpatient services.
• Conducts claims analysis before submission to insurance companies by Finance.
• Reconciles claims paid and outstanding with insurance companies and coordination with Finance.
• Demonstrates functional and business knowledge required for the job and applies that in following the requirements of Insurance Companies in the Hospital.
• Anticipates and sets priorities to support department needs and follows policies and procedures for achieving them.
• Identifies and analyses problems takes action to resolve them, applies sound judgment, and takes responsibility for their resolution.
• Supports the Hospital Policies and Procedures.
• Supports the Department Policies and Procedures.