Insurance Doctor

Join My Clinic, the leading multispecialty outpatient care provider in Saudi Arabia, where our mission to help people live longer, healthier, and happier lives drives everything we do. Since 2017, we've been at the forefront of healthcare, combining innovation with a deep commitment to care, collaboration, ambition, and responsibility. As we continue to grow and reach new heights, we're looking for passionate individuals who share our vision and values.

Job Summary:

Insurance Doctor is primarily responsible for utilizing patients' electronic health records to code medical procedures and examine insurance claims. Communicating with insurance companies, updating internal billing databases, electronically storing patients' records, analyzing insurance requests, detecting coding errors, and verifying medical coverage.

Primary Responsibilities:

1. Multisite management on pre-authorization and claims management.
2. Optimizing the revenue, average unit cost and services’ utilization.
3. Pre-authorization management and improve the rejection percentage.
4. Guiding and improving pre-authorization team performance.
5. Insurance awareness for the medical team guided by the rejection’s loss tree.
6. Following up completing the orders once done by the patients
7. Insurance awareness sessions for the operations staff to discuss the regulations updates.
8. Actively participation in complaints management and executing the corrective actions.
9. Collaboration with the stakeholders concerned to optimize the revenue by reducing the rejections.
10. Perform other professional duties requested from line manager.

Education / Professional Qualifications:

1. Education Degree: M.B.B. Ch
2. Years of Experience: Minimum of 3-5 years
3. License: SCFHS (preferable)
4. Professional Certification: I.F.C.E

Experts & Skills:

1. Excellent Command of oral and written English
2. Good communication skills dealing with both internal and external customers
3. Microsoft knowledge and skills (particularly EXCEL)