Ref: HP704-545

Job description / Role

Employment: Full Time

The Medical Approval Team Leader is responsible for controlling and leading the Medical Approval team and liaising with various offices within Middle East, UK & USA in order to provide high level of customer medical necessity and satisfaction; the incumbent will be reviewing and approving payment on pre-approvals received from hospitals/clinics on medical cases.

Main functions and responsibilities:
- Review and approve payment against Pre-approvals received from providers on medical cases
- Monitor day to day activities of the team, assign tasks/objectives/schedules to team members.
- Support the team for any query in terms of medical cases, clients’ and providers complaints, insurance coverage, and problems in the system or pending cases in the system.
- Coordinate and liaise between Medical Team and various offices
- Consult with US/UK medical team & client managers for information related to members’ medical cases and insurance details.
- Manage the Prescription Benefit Management System by setting the rules of insurance policies, terms & medical cases related to providers and members.
- Coach, develop and guide team members.
- Conduct performance appraisal for the team and track their skill improvement.
- Report regularly the team’s performance to the Medical Approval Manager.
- Ensure the Company policies and procedures are implemented by all team members.
- Provide continuous evaluation of processes and procedures for the Department and suggest methods for processes improvement.
- Generate Medical Approval reports whenever requested.
- Miscellaneous tasks within the scope of work, as assigned by the direct manager.
- Capture, report and follow any complaint concerning the Approval Department.

Requirements

- Communication skills
- Customer focus
- Organizational skills
- Managerial skills
- Medical Doctor is mandatory
- Medical Insurance certificate
- 5 years’ experience in health Insurance field
- Microsoft Office: proficiency in Excel & Word

About the Company

Established in 1996, Clarendon Parker Bahrain is an International Recruitment Specialist Consultancy based in Bahrains Seef Business District. We specialise in mid to senior level professional, managerial, technical recruitment and staffing solutions in Bahrain and beyond. Our multinational team of consultants are experienced professionals within the fields they represent. Each consultant brings strong industry links and knowledge to better understand your business requirements. We know the market and we know our candidates!

Our team of dedicated consultants specialise in the following industries:

Accounting, Finance & Banking Logistics & Customer Service Secretarial & Administration Human Resources & Recruitment Engineering & Construction IT/Telecom Marketing & PR Oil and Gas

The current range of services includes permanent and temporary recruitment, recruitment advertising campaigns, employee satisfaction surveys, state-of-the-art web-based recruitment technology and HR consulting services relating to recruitment processes and activities.

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