تنفيذي إدارة شؤون المرضى

Responsible to provide a range of duties including greeting patients when they enter the medical facility, confirming and registration of new patients, insurance, answering calls and checking emails on a regular basis.

Responsibilities

• Greet patients, direct them to appropriate departments and provide routine information about the hospital when necessary.

• Check emails daily, ensuring you respond to queries in a timely manner.

• Ensure operations are carried out uniformly according to the hospital policies and procedures.

• Contributes to team effort by accomplishing related results as needed and maintains safe and clean reception area by complying with procedures, rules, and regulations.

• Participate in the Hospital training programs.

• Ensure complaints are handled in a structured, timely and professional manner which is fair, courteous and respectful of privacy, to identify problems and to continuously improve the department's services.

• Follows the duty schedule as assigned by the team leader/supervisor which includes different shift timings as per the need of the department

• Strictly adheres to NMC’s regulations and policies especially those related to infection control, patient safety & JCI.

• Supports Continuous Quality Improvement and participates and contributes to all the quality assurance activities of the service.

• Exercises effective interpersonal skills in dealings with department staff, colleagues and management.

• Maintains patient & staff confidentiality.

• Maintain high standards of data accuracy while ensuring compliance with privacy regulations.

• Verify patients’ insurance coverage and eligibility .

• Maintain updated records of insurance policies, benefits, and limits.

• Keep the pending approval monitoring system updated for the next days follow-up.

• Ensure correct documentation is attached for claims

• Resolve discrepancies.

• Educate patients about their insurance coverage, co-payments.

• Handle patient queries regarding claims, approvals, or reimbursement.

• Maintain accurate records of all insurance claims and payments.

• Work closely with the front desk, billing team, and clinical staff to ensure accurate documentation and billing.

• Assist in resolving billing discrepancies related to insurance.

• Stay updated on insurance policies, regulations, and guidelines.

• Ensure compliance with insurance rules and clinic policies.

• Enter new patient information and update in our system.

• Guide the staff to follow the correct ICD&CDT codes to avoid the rejection.

• Coordinating with head office insurance team for escalations when required

Keeping all insurance records updated and ready for audits/inspections.

Qualifications

College Diploma - Any discipline or related fields.