Insurance Administrator

Job description / Role

Job overview: To work closely with the insurance coordinator to ensure the smooth flow of the daily activities with a primary focus on pre-approvals thereby reducing disallowances and patient complaints. Interact with customers and provide insurance claims-related information in response to patients inquiries. Ensure ontime and accurate insurance claims processing.

Key responsibilities of the role:
- Prepare cost estimates for various out-patient and in-patient cases.
- Assist the Insurance Coordinator to source insurance approvals
- Contact Insurance Companies for verbal approvals as required
- Review the In-Patient list and the Operating Theatre list to ensure an understanding of current approval statuses
- Review and distribute the pre-approvals to concerned departments in a timely manner
- Identify unusual denials and medical report requests and contact the Insurance Companies for clarification and resolution
- Provide expert advice on various insurance policies and coverage to external and internal clients
- Communicate effectively between doctors and Insurance Companies when further information is required
- Maintain and update the approval log
- Review pending cases and follows up on these to ensure swift resolution
- Coordinate with external and internal clients for approval-related information
- Distribute insurance related updates to all relevant areas of the Hospital
- Update the Insurance Manager about any unusual denials/issues from Insurance Companies and provide recommendations for resolution
- Assist the insurance Manager to manage reconciliation related issues
- Establish and maintain the approval files for easy access for the Dispatch and Resubmission team

Requirements

- Relevant tertiary diploma or degree
- Qualification in a medical-related course is an advantage but not required

Skills/Abilities/Experience Required:
- Medical insurance background, preferably in a healthcare industry.
- Experience working with / liaising with local insurance companies
- Knowledge of medical terminology will be an advantage
- Above average computer literacy and a good working knowledge of Microsoft Office.
- Above average verbal and written communication skills.
- Coding experience is an advantage
- Ability to analyze statistical data
- Fluency in English is required and Arabic language skills will be well regarded
- Proficiency in MS Office applications.
- Experience working in a similar position
- Ability to perform tasks completely and accurately within set time frames
- Ability to work independently within set guidelines.
- Experience in providing good customer service
- Good attention to detail

About the Company

Mediclinic Middle East is part of Mediclinic International, one of the top 10 listed private hospital groups in the world with 52 healthcare facilities in Southern Africa, 14 in Switzerland under the name Hirslanden AG and 10 in the UAE. Their headquarters are in Stellenbosch, South Africa.

Previously EHL Management Services, the company became Mediclinic Middle East when its majority shareholder, Mediclinic International, acquired all remaining shares from its partners Varkey Group and General Electric in October 2012.

Mediclinic Middle East owns and operates some of the most respected healthcare facilities in the region. These include Mediclinic Welcare Hospital, Mediclinic City Hospital, Mediclinic Dubai Mall, Mediclinic Ibn Battuta, Mediclinic Meadows, Mediclinic Arabian Ranches, Mediclinic Mirdif, Mediclinic Al Qusais, Mediclinic Al Sufouh and Mediclinic Beach Road.