Approval Officer
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Key skills for this role
About the Role
Under the supervision of the Audit Team leader; reviews, sends and follows-up preapproval requests received from various departments in the facility. Coordinates with the Billing Team and other teams of RCM Department in regards to any concerns relating to pre approvals.
Key Skills for This Role
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Overview
- Under the supervision of the Audit Team leader; reviews, sends and follows-up preapproval requests received from various departments in the facility.
- Coordinates with the Billing Team and other teams of RCM Department in regards to any concerns relating to pre approvals.
- Responds to quires related to insurance coverage/Approvals of patients and assists in the same regard.
- Assists in training newly inducted staff on various insurance protocols.
- Monitors, dispatches approvals, and follows up on pending and rejected cases.
- Coordinates with doctors of NMC Hospital DIP and insurance companies regarding justification of rejected approvals.
- Coordinates with PRO, Billing, and Front Office teams for updating approval status.
- Handles all insurance-related queries from staff and patients.
- Prepares daily productivity reports as requested by management and supports month-end reporting.
- Improves business relations through uniform, equitable, and transparent application of NMC Hospital DIP policies.
- Assists in the development of unit policies and procedures within the RCM Department.
- Manages general office administration in the absence of the Team Leader.
- Bachelor’s degree (preferably in Nursing, Coding, or a paramedical field) with experience in the insurance or healthcare industry.
- At least 3 years of experience in the health insurance or healthcare sector.
- Basic knowledge of computers and Microsoft applications.
- Fluent in spoken and written English. Spoken Arabic is advantageous but not essential.
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