Insurance Compliance Officer

About the Role

Dr Sulaiman AlHabib Medical Centers is seeking a dedicated and experienced Insurance Compliance Officer to join our team. This full-time role is integral to ensuring the accurate and timely processing of insurance policies and the efficient management of patient accounts within our medical facilities.

Role Overview

The Insurance Compliance Officer is responsible for overseeing the comprehensive process of insurance policy management, from initial preparation and system entry to modifications, renewals, and cancellations. A key aspect of this role involves ensuring data accuracy, resolving billing issues, and providing essential support and training to staff regarding policy changes and compliance.

Key Responsibilities

• Prepare and distribute Ready Reference Tables for all company (regular and insurance) policies.
• Process and enter all company (regular and insurance) policies and related information into the Pharmacy system, ensuring all required administrative and management approvals are obtained.
• Provide updates and information to the Patient Services and Nursing Departments regarding new, updated, or modified company and insurance company details after system entry.
• Manage modifications, renewals, and cancellations for all company (regular and insurance) policies, ensuring timely system updates.
• Review and verify the correctness and accuracy of all company (regular and insurance) data, both during initial entry and for existing records in the system.
• Identify companies and insurance providers with exceptional conditions to facilitate contract review for renewal purposes.
• Monitor the status of patient accounts and actively assist in identifying and resolving billing and processing discrepancies.
• Analyze existing billing processes and recommend improvements to enhance efficiency and accuracy.
• Conduct audits on problem accounts to ensure compliance and resolution.
• Notify and train relevant staff members on significant policy or process changes.
• Advise the Director of Business Services on departmental problems and concerns.
• Supervise assigned personnel, contributing to their training, orientation, and performance evaluation.
• Participate in and lead person-centered care initiatives undertaken by HMG, enriching patient experience with compassion, respect, and dignity.

Qualifications and Experience

• A minimum of 5 to 10 years of experience in insurance compliance, policy processing, or a related administrative role within a healthcare setting.

Required Skills and Attributes

• Strong attention to detail and accuracy in data management and policy processing.
• Excellent analytical and problem-solving skills, particularly in identifying and resolving billing issues.
• Proficiency in using relevant systems for policy entry and data management (*, Pharmacy system).
• Effective communication and interpersonal skills for staff training and inter-departmental coordination.
• Ability to supervise and mentor team members.
• Commitment to patient-centered care and service excellence.

Join Our Team

If you possess the required experience and skills for this full-time role, we encourage you to apply and contribute to the high standards of Dr Sulaiman AlHabib Medical Centers.