Insurance Manager - SAC
Job Summary
Responsible for the insurance function with the objective of streamlining the process of patient insurance claims and recovery through effective liaising with insurance companies while maximizing patient satisfaction. Responsible for overseeing the insurance operations and designing, implementing and training staff on insurance protocols.
Job Responsibilities 1
Key Outputs Prospective Insurance companies identified, agreements reviewed, the selection made, and contracts awarded.
Insurance policies implemented after the agreement is signed.
Follow up and negotiations with Insurance Companies where needed to ensure approval of problematic cases.
Exhausted benefits identified in close liaison with re-submission team to ensure maximum recovery from Insurance companies.
Insurance protocols complied with at all times.
Disallowance reconciliation and mutual settlement coordinated with Insurance Companies.
Insurance disallowance write-offs coordinated with Accounts Receivables department after proper reconciliation.
Disallowance reasons evaluated, improvement areas identified, and changes implemented.
Job Responsibilities 2
Regularly review outstanding claims and liaise with the Management/Finance Department to ensure the adequacy of claim reserves.
Prepare all statistics required by Management including rejections, insurance company breakdown of revenue & claims.
Achieve monthly team targets in terms of claims processed. Communicate with other department managers pertaining to issues related to claims processing and vice versa.
Oversees operational systems, processes, and infrastructure while looking for opportunities of improvement or revision.
Anticipates and tracks insurance and tactical risks and providing strategic solutions.
Manages day to day business of the Insurance department while balancing the responsibilities of various business lines such as business analysis.
Oversees and reports weekly, monthly, quarterly, and annual metrics.
Identifies trends and assess opportunities to improve processes and execution.
Additional Responsibilities 3
Job Knowledge & Skills
• Administration and Management.Production and Processing.Good interpersonal and communication skillsCritical decision-making skillsStrong customer service commitmentCompetent Computer Skills.Organized and able to work methodically.Presentable, pleasing personality with a professional attitude as well as confident and enthusiastic.Pro-active and able to successfully prioritize competing priorities.Able to efficiently multi-task
• ERP knowledge preferably SAP functional skills are a requirement to be successful in this role.
Job Experience
Total of 10 years work experience
5 years industry related experience
3 years in the GCC region (Preferred)
Competencies
Education