Insurance Manager

Career Opportunities:
Insurance Manager (1663)

Requisition ID

1663
• Posted -

Finance and Accounting
Responsible to handle a variety of insurance functions, that includes, liaison with insurance companies in the delivery of healthcare services to insured patients, insurance coverage for employees. Obtain information from insured or designated persons for purpose of settling claim with insurance carrier and in overall responsible for insurance collection process and performing related work as required.
Main Duties and Responsibilities/Performance Standards
Responsible for timeline submission and resubmission of medical claims while ensuring minimum processing errors. Works with insurance carriers and vendors in resolving customer issues or concerns.
Responds to all customer / insurance company's inquiries regarding insurance formalities and billing. Oversees updating of insurance database in line with each medical insurance policy. Ensure periodic updates to the healthcare services pricelists. Lead the process of reconciling health and life insurance carrier bills for Large Group accounts.
Responsible for liaising with corporate clients and individuals for settlement of their periodical dues and to posts insurance payments and contacts insurance company regarding unpaid claims. Arranges to receive letters of guarantee from overseas insurers prior to delivery of healthcare.
Responsible for reducing the medical rejection rates:
Investigate the reason for every denied claim; focus on resolving the issue, resubmitting the request to the insurance company and filing appeals where required and liaising with the doctors on fixing the claims.
Liaising the quarterly and annual audit reviews from the insurance companies and resolving for any possible financial implications. Supporting CFO with the needed inputs for final settlements and reconciliation of the rejected claims.
Guiding and supervising medical claim officers and ensuring timely re-submission of claims to the insurance company as per assigned schedule and target dates
Process & workflow automation:
Reduce efforts to check the claims' status by improving the adoption of web portals to obtain claim status online. Defining claims follow-up work queues with web-based workflow systems that improve the documentation quality.
Timely review of pre-approval rejection trends and minimizing opportunity loss.
Organizing and leading departmental meetings, trainings and educational programs.
Performs miscellaneous job-related duties as assigned by the CFO.
Ensures quality and patient safety practices are followed (occupational and patient safety).
Provides and promotes people centered care.
Promotes inclusive health by providing equitable and accessible care to patients and families with special needs.
Qualifications, Competences and Skills
Education:


Bachelor's degree in commerce / science/medicines
Experience :
At least 2 to 4 years of experience directly related to the duties and responsibilities specified.
Licensure :
Not Applicable
Language :
Well versed in Arabic and English languages - to read and to write; Computer literacy - highly skilled in the use of spreadsheets and word processing packages.
Performance Competencies
Knowledge of basic medical insurance claim forms and procedures, simple posting methods and computer terminal operations.
Ability to understand and complete insurance claim forms, post claims and payments, understand basic medical insurance policies, answer questions regarding claims, coverage and payments, establish and maintain an effective working relationship with the public and other employees.
Ability to work independently on a variety of responsible clerical tasks.
Ability to calculate numbers, correct entries, and post to records to analyze and solve problems, has Ability to communicate effectively, both orally and in writing.
Principle Working Relationships and Remarks
Finance & Reception Staff; Insurance Companies; Patients Claiming Insurance
Other Preferences
Candidates who are available in Kuwait and possess a valid and transferable visa in Kuwait will be preferred.
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