Approval Specialist

Overview

International HR Coordinator at Gruppo San Donato, MENA Region

About the Role

We are looking for a dedicated and detail-oriented Approval Officer to act as a key liaison between patients, hospital departments, and insurance providers. The ideal candidate will manage all insurance pre-approval activities, ensure eligibility verification, and support patients in understanding their coverage to deliver seamless healthcare service.

Responsibilities

• Act as a point of contact for all approval requests for internal and external patients with all insurance companies, and resolve issues related to rejected and pending approvals, and ensure fast service.
• Ensure that patient insurance policy is eligible and covers the required treatment, stay, or operations to avoid rejections.
• Ensure the delivery of best-in-class service for patients, provide clarification regarding policy, medical rejection, pending requests to contribute to patients’ satisfaction and overall hospital image.
• Review all patients' requests related to medical and pharmaceutical, diagnosis, and RMI and ensure that the insurance policy covers them.
• Ensure following CHI, SFDA protocol, policies and procedures when executing insurance activities.
• Ensure the documentation of all approval activities to ensure the accuracy and completeness of working papers, analysis, and results to support findings and recommendations.
• Ensure uploading the "Table of Benefits" in the hospital system for in and outpatient, with an accuracy of patient deductible, approval limit, service inclusions / exclusions, and ensure all contracts / policies are assigned to the correct price.
• Review and submit all approvals on time.
• Provide insurance companies with request documents and follow up all pending requests.
• Confirm and analyze insurance patients' data with the submitted data to avoid any confusion, fraud, or rejection.
• Support in resolving issues related to rejected and pending approvals.
• Respond to patient inquiries regarding medical insurance and coverage status.

Qualifications & Requirements

Seniority level

Employment type

Job function

Industries

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