Director-Healthcare Insurance

The purpose of this role is to lead the business development initiatives while implementing policies, procedures, and controls to achieve the organizational vision, mission, and strategic goals. Participates in the strategic planning and operational management and ensures the quality, effectiveness, and efficiency of clinical and support service provided. Ensure that the fabric and structure of the facility remain fully fit for purpose and being the principle point of contact between the facility executive and corporate departments ensures that external utilities including security, housekeeping, gardening, transport, catering, copy center, laundry and mail services meet the facilities requirements Key Accountabilities .

Designs, updates and implements policies, procedures and protocols to ensure efficiency and accuracy in insurance operations. .

Conduct weekly departmental meetings with staff for updates and to educate them on new work methods .

Ensure that insurance claims are processed in a timely manner and resolve issues that arise during process. .

Follow up and negotiate with Insurance Companies where needed to ensure approval of problematic cases. .

Oversee administration of medical services to Insurance and Corporate patients or/and customers of the Hospital. .

Liaise with insurance companies regarding eligibility, payments, reconciliation and other requirements. Organize training session for concerned employees to develop their understanding of insurance policies and condition. .

Review insurance claims to ensure accuracy as per agreement, prior to dispatch to respective insurance companies. .

Proactively report critical issues to Management and submit monthly aging and other reports to line manager .

Responsible for following up and monitoring the collection of all receivables. .

Monitor insurance discounts, rejections and prepare & submit periodic reports to the line manager for review. .

Ensure that the insurance schemes are up to date on the system. .

Attending and organizing the insurance presentation internally and externally. .

Provide the necessary guidance and on-job coaching and in-service training for the staff under direct supervision. .

Assume new responsibilities as and when needed. .

Prepare all statistics required by Management including Claim cost, Average Claim Ratio etc. Essential Job Requirements Education Any Bachelor’s Degree