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Insurance Pharmacist

2 months ago

Jeddah, Makkah Province, Saudi Arabia My Clinic KSA Full time

At My Clinic KSA, we are committed to delivering exceptional patient care and innovative healthcare solutions. As a key member of our team, you will play a vital role in ensuring seamless insurance experiences for our patients.

**Job Summary:**

We are seeking a highly skilled and detail-oriented Insurance Pharmacist to join our team. As an Insurance Pharmacist, you will be responsible for providing expert support to our pharmacists, insurance companies, and patients to ensure efficient and effective insurance claims processing.

**Key Responsibilities:**

  • **Collaborate with Pharmacists:** Work closely with our pharmacists to resolve insurance-related queries and provide guidance on insurance policies and procedures.
  • **Pre-Authorization Support:** Follow up on rejected pre-authorization requests, process them for approval, and communicate with insurance companies to gain approval for medications.
  • **Insurance Communication:** Establish and maintain relationships with insurance companies' doctors and delegates to facilitate approval for medications.
  • **Claims Management:** Manage and handle missed pre-authorization requests, ensuring timely resolution and minimizing delays.
  • **Policy Updates:** Stay up-to-date with new insurance companies' policies and medical guidelines to apply exceptions or additional rules, enabling fast decision-making and approval processing.
  • **Patient Support:** Provide clear explanations to patients about their insurance coverage, addressing any related queries and concerns.
  • **Data Analysis:** Perform data analysis on rejected medications to identify and prevent future rejection reasons.
  • **Training and Development:** Train front-line pharmacists on insurance details, ensuring they are equipped to provide excellent patient care.
  • **Additional Responsibilities:** Perform other professional duties as requested by the line manager, contributing to the overall success of our team.

**Requirements:**

  • **Education:** Bachelor's degree in pharmaceutical sciences or higher.
  • **Experience:** Minimum of two years' experience in the same field.