Claims Coordinator📣 Job Ad

About the Role

National Medical Care is seeking a Claims Coordinator to join our team in Riyadh, Saudi Arabia. This full-time role is central to facilitating patient admissions and special services by managing the approval process with various insurance and direct companies. The Claims Coordinator ensures timely communication and coordination regarding patient claims and adherence to quality standards in patient care.

Key Responsibilities

• Ensure, directly or indirectly, that superior quality medical treatment, compassion, and understanding are provided to every patient at NMC Hospitals and Clinics.
• Receive claim forms from nurses or patient relatives for admission approval purposes.
• Verify the accuracy of the attached ID copy on received claim forms.
• Review the UCAF form in the system to confirm that requested investigations for admitted patients have been entered by the encoder.
• Prepare and send printed UCAF forms via fax or email to the concerned insurance or direct companies.
• Follow up with companies by phone to secure necessary approvals.
• Receive approval or disapproval notifications via fax or email, and convey this information to the patient and the Admission office.
• Coordinate with the concerned physician if the insurance company requires further justification for services.
• Enter acquired approvals into the Hospital Management Information System (HMIS).
• Liaise with insurance companies regarding extensions of patient stay.
• Promptly inform the business unit if an insurance company disapproves extended days or specific services.
• Submit all cases admitted through the Emergency Room (ER) to the respective insurance companies.
• Perform additional tasks and duties as assigned by superiors.

Reporting Structure

The Claims Coordinator reports directly to the Head of Patient Accounts. This role does not involve supervisory responsibilities.

Required Experience

Candidates should possess 5 to 10 years of relevant experience in claims coordination or a similar administrative role within a healthcare setting.

Work Type and Location

This is a full-time position based in Riyadh, Saudi Arabia.

Application Information

We invite qualified candidates to apply for this opportunity to contribute to patient care coordination at National Medical Care.