Job Purpose

• Supervisesing and follows up on the implementation of the necessary processes to communicate with employees and insurance companies to achieve the requirements of health services for employees.

Job Responsibilities

• Coordinates the addition of monthly treatments to those who are entitled to it, in order to ensure that they receive them in an easy way.
• Solves any problems related to renewing the monthly treatment for employees in terms of adding, deleting or modifying the prescribed medications in order to satisfy the customer.
• Updates the monthly treatment prescriptions periodically in order to ensure that employees need it.
• Explains the method of cash recovery and clarifies the documents and invoices that are required to be available in case any action is taken outside the network in order to satisfy the customer.
• Receiving documents and invoices from the employee in order to ensure their validity.
• Supervises the delivery of documents and invoices to the recovery department of the insurance company in order to achieve the requirements of the insurance company.
• Follows up and finalizes recovery operations and receives their results from the company in a timely manner in accordance with the contract in order to ensure the correctness of the procedures.
• Delivers and communicates the results to the beneficiaries, whether accepting or rejecting, and explaining the reasons for rejection in order to satisfy the customer.
• Periodically monitors employee consumption with the aim of making recommendations to senior management.
• Verifies actions that harm the use of the service by employees for the purpose of implementing regulations.
• Takes the necessary measures to avoid problems related to the use of the service and spreads awareness among the employees with the aim of satisfying the customer.
• Supervises and reviews all procedures for obtaining approvals for surgeries in order to explore the possibility of performing them at El-Araby Hospital.
• Communicates with service providers in order to help employees obtain distinguished service.

Qualifications

• Bachelor's degree in the faculty of pharmacy or any relevant field.
• Minimum 4 years of experience in the medical insurance field.
• Males and Females are welcome to apply.
• Excellent administrative and supervisory skills.
• Good communication skills.
• Understand medical terminology.
• Excellent interpersonal skills.
• Ability to build relationships with a variety of medical providers.
• Problem solving skills.
• Microsoft office proficiency.
• English language skill.