MedNet Jordan is one of the leading managed care service organizations that caters to healthcare needs. We are currently seeking to hire an Officer – Authorization (on Hybrid working modules basis) with the following tasks and responsibilities:
Your Job
Medical Claims Evaluation:
· Authorization for in-hospital cases in respect of medical necessity and appropriateness.
· Evaluation & approval of outpatient claims need authorization in respect to the medical necessity and appropriateness and check them on the system to ensure high quality and correct services.
· Chronic soap evaluation, issue, checking, sign & stamp.
Business Correspondence
· Manage queries from providers, Insurance Companies and insured members relating to authorization, evaluation and administration.
· Responding to all international accounts requests and all inquiries from insurance companies.
Client Servicing
· Deliver excellent customer services to Insurance Companies and insured members with view of achieving maximum client satisfaction.
Administrative Services
· Medical Updating of the Medical File related to insured members regarding their investigations results like MRI, CT scan, etc....
· Filling of Medical Documents.
· Any other tasks assigned by Direct superior /Head of department.
Your Profile
· Bachelor Degree in Nursing Science, Pharmacy, Paramedical certificate.
· From 2 - 4 years' experience in his/her education field.
· Experience in claims management in the insurance industry or a TPA/MSO company would be a plus.
· Good interpersonal and negotiation skills
· Excellent written and verbal communication skills
· Analytical and problem-solving skills
· Ability to handle stress and work under pressure.
· Client Centricity approach
· Solution Oriented.
· Proactive approach