Senior Medical Eligibility Analyst
6 months ago
Handles patients and staff with medical eligibility problems and issues; coordinates with other departments as necessary.
**Essential Responsibilities and Duties**:
1. Provides Assist to patients, employees, and other hospital staff regarding medical eligibility issues and cases.
2. Address inquiries and questions, offering guidance and clarification on eligibility-related matters.
3. Reviews and analyses various documents to determine the eligibility of patients and employees for medical services.
4. Reviews and forwards relevant information regarding discharged patients and eligible specialties to appropriate departments.
5. Evaluates eligibility criteria based on established guidelines, policies, and regulations.
6. Maintains accurate records and documentation of eligibility determinations.
7. Receives and processes persons/patients with referral letters.
8. Performs clinical responsibilities within related specialty such as (Nursing, Laboratory, Respiratory, Pharmacy, etc.) as assigned.
9. Processes Medical Treatment Exceptions for non-Saudi patients who have a Royal Order.
10. Coordinates with physicians regarding delayed medical information.
11. Submits periodic reports of activities.
**Education**:
Bachelor’s Degree in Nursing is required.
**Experience Required**:
Four (4) years of related experience is required.
**Other Requirements(Certificates)**:
- Saudi Nationals Only.
- Current license to practice as a Registered Nurse is required.
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