ABOUT US

Fakeeh University Hospital delivers the best possible outcomes for its patients through smart technology and academic strengths. Built on an integrated healthcare model, the hospital brings you the legacy of over four decades of compassionate care – drawn from the renowned Fakeeh Care group based in Saudi Arabia.
Fakeeh University Hospital is made up of like-minded healthcare providers, working towards a common goal, which is, delivering quality healthcare to people all around the world. Our passionate staff members have years of experience within and outside the country.
Fakeeh University Hospital is a digital hospital, having fully integrated electronic medical records, supporting improvements to the quality and efficiency of healthcare services for patients and the community at large. Additionally, we operate an efficient emergency department

JOB PURPOSE:

• Coordinate with appropriate personnel to ensure that all the formalities as agreed with the insurance companies are followed to minimize objections from them and delays in clarifications to the insurance companies.
• Co-ordination with Registration, Admissions, Finance and Insurance Companies on direct billing arrangements on all insurance matters like authorizations, case management, audit and claim submissions
• Coordination with Physicians & other personnel to ensure that all the formalities as agreed with the insurance companies along with meeting patient care standards based on evidence-based practice.
• Arrange meetings with Physicians and Insurance Companies when a request is raised and hold such discussions.
• Meet with Physicians for cases/feedback from Insurance Companies.
• Ensure all authorization requests are sent out before the end of business day with completed details
• Ensure follow up of pending authorization so that services are completed for the patient.
• Review and analyse charges for all Inpatient & ICU/CICU (long stay patients) to meet E claims requirements. Evaluate claims based on CPT guidelines.
• Ensure IP Claims analysis is completed prior to their submission to insurance companies.
• Analyse rejection reasons & trends so that appropriate discussions can be arranged with treating Physicians. Identify and analyse problems & take action to ensure that processes are revised to avoid such rejection sin the future
• Hold discussions with Insurance Companies to respond to recons and payments in case of delays.
• Work with the coding team in reconciliation and resubmission of rejected claims.
• Train new team members and mentor them.

KEY RESPONSIBILITIES AND DUTIES:

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Experience:

• a minimum of 5 years’ experience of working in Revenue Cycle Management in UAE or
• Claims and Authorization Team in an Insurance Company

OTHERS:

Quality Improvement (Safety, Risk Management):

• Participates in continuous quality improvement projects, and Departmental projects.
• Demonstrate a safe working environment through compliance with Hospital Policy and Procedure regarding safety & infection control.
• Promote and maintain a culture of safety.

Patient Experience:

• Participates in customer service trainings
• Encourages customers to respond to Satisfaction Survey 

Conditions:

• The job description is subject to periodic review and may be updated as necessary. All job descriptions are reviewed every 3 years or more often as deemed applicable to ensure they remain relevant.

COMPETENCIES: