Ip Approvals Dr

3 weeks ago


Riyadh, 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 pre-approval 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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