Ip Approvals Dr

2 weeks ago


Riyadh, Ar Riyāḑ, Saudi Arabia Sawaid Full time

We are looking for a " IP Approvals Dr "
to join a Supportive Healthcare And Health Insurance
company in Saudi Arabia
:

The location work in Riyadh.

What your Responsibilities**:

  • Reviewing the UCAFs prior to submitting them to insurers to make sure that all necessary information is filled, required services are medically justified and the diagnosis/ service codes are inserted correctly.
  • Ensure that MOH clinical guidelines are applied.
  • Check the beneficiary medical coverages and plans.
  • Contact the treating physicians for medical enquiries.
  • Discuss pending approvals with insurers' approving physicians/Roving doctors.
  • Raise flag for unjustified cases to be reviewed.
  • Determine the level of urgency for the ER cases.
  • Timely meets the deadlines.
  • Reporting trends related to preapproval to reporting Supervisor.

What are the requirements and qualifications required for the job:

  • 2 to 5 Years experience in
    IP Approvals Dr.
    on similar role at other hospital or insurance company.
  • Bachelor's Degree in Medicine.
  • Medical field background. (Doctor).
  • Medical coding knowledge, Medical Billing Knowledge.
  • Good Knowledge on medical practices and guidelines.
  • Good Knowledge with CHI regulations and coverage.
  • Very Good in English Level.
  • Proficient in the software modules. (MS
  • Word and Excel).


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