Claims Coordinator📣 Job Ad

About the Role

National Medical Care Company (Care) is seeking a dedicated Claims Coordinator to join our team in Riyadh. This full-time role is central to managing the approval process for patients requiring admission and special services across NMC Hospitals and Clinics. The coordinator plays a vital part in ensuring the delivery of superior quality medical treatment, coupled with compassion and understanding for every patient.

Key Responsibilities

• Receive claim forms from nursing staff or patient relatives for admission approval.
• Verify the accuracy of the attached identification copy on each claim form.
• Access the UCAF form within the system to confirm that requested investigations for admitted patients have been correctly entered by the encoder.
• Prepare and dispatch printed UCAF forms via fax or email to the relevant Insurance or Direct Company.
• Proactively follow up with companies to ascertain approval status through phone communication.
• Receive approvals or disapprovals via fax or email and promptly communicate these decisions to the patient and the Admission office.
• Liaise with the concerned physician if the Insurance Company requests further medical justification.
• Input acquired approvals into the Hospital Management Information System (HMIS).
• Coordinate with the insurance company for extensions of patient stay days when necessary.
• Immediately inform the business department if the Insurance Company disapproves extended days or services.
• Submit all cases admitted through the Emergency Room (ER) to the Insurance Company.
• Undertake additional tasks and duties as assigned by superiors.

Qualifications and Experience

Candidates for this role should possess 2 to 5 years of relevant experience, demonstrating a solid understanding of claims coordination within a healthcare setting.

Work Environment and Location

This is a full-time position based in Riyadh, Saudi Arabia. The role operates within the dynamic environment of National Medical Care Company (Care), contributing to patient care and administrative efficiency.

About National Medical Care Company (Care)

National Medical Care Company (Care) is dedicated to providing high-quality medical services. We are committed to patient well-being and maintaining efficient administrative processes across our hospitals and clinics.

Application Information

We invite qualified candidates to apply for this opportunity to contribute to our mission of delivering excellent patient care.