Total des années d'expérience: 8 Années, 10 Mois
mai 2015
A À présent
Director Of Insurance
à Hayaty Clinic
mai 2015
A À présent
Claims Manager & Insurance Director
à Hayaty Clinic
Lieu :
Arabie Saoudite - AlAhsa
Responsible directly on the following :-
1 - all front desk staff ( reception, appointment, approvals, medical records, clerks, claims, AR accounting & insurance department staff ).
2 - check all insurance patient registration process & make sure that its correct and complete .
3 - check all insurance patient ( UCAFF, OCAF, DCAF ) and make sure that its filled completely from the doctors and justified for the claim or approval according the patient diagnosis.
4 - check pre authorizations, approvals for the patient and make sure that its submitted in the proper way and coordinate with the doctors and patients to update them about any results also negotiates with insurance regarding the approval coverage, and details or patients history if needed .
5 - submit the claims to the insurance companies and check it before that to make sure that its complete and make sure that it will be submitted within the allowed period from the insurance company and it will not delayed.
6 - follow-up with insurance companies in respect of payments due to claims and make sure to pay them as soon as possible .
7 - studying rejections and coordination with doctors to respond appropriately and negotiate with the insurance company regarding that and collect the biggest possible amount from these rejections, Also analyze the reasons for these rejections and avoid them in the upcoming claims and continue to feed the system and develop procedures in the process of claims so as not to repeat these discounts.
8 - patients satisfaction and their affairs department of in addition to study the problems they face and analyze and develop appropriate solutions in relation to them to ensure that all internal operation will go on fast and smooth
1 - all front desk staff ( reception, appointment, approvals, medical records, clerks, claims, AR accounting & insurance department staff ).
2 - check all insurance patient registration process & make sure that its correct and complete .
3 - check all insurance patient ( UCAFF, OCAF, DCAF ) and make sure that its filled completely from the doctors and justified for the claim or approval according the patient diagnosis.
4 - check pre authorizations, approvals for the patient and make sure that its submitted in the proper way and coordinate with the doctors and patients to update them about any results also negotiates with insurance regarding the approval coverage, and details or patients history if needed .
5 - submit the claims to the insurance companies and check it before that to make sure that its complete and make sure that it will be submitted within the allowed period from the insurance company and it will not delayed.
6 - follow-up with insurance companies in respect of payments due to claims and make sure to pay them as soon as possible .
7 - studying rejections and coordination with doctors to respond appropriately and negotiate with the insurance company regarding that and collect the biggest possible amount from these rejections, Also analyze the reasons for these rejections and avoid them in the upcoming claims and continue to feed the system and develop procedures in the process of claims so as not to repeat these discounts.
8 - patients satisfaction and their affairs department of in addition to study the problems they face and analyze and develop appropriate solutions in relation to them to ensure that all internal operation will go on fast and smooth
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