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

Education :

Bachelor’s Degree (preferably in a Medical or Healthcare-related field). Experience :

1–2 years of relevant experience in Healthcare Insurance or Revenue Cycle Management (RCM). Seniority level

Associate Employment type

Full-time Job function

Health Care Provider Industries

Hospitals and Health Care

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