Director-Healthcare Insurance

The purpose of this roleis to lead the business development initiatives while implementingpolicies, procedures, and controls to achieve the organizationalvision, mission, and strategic goals. Participates in the strategicplanning and operational management and ensures the quality,effectiveness, and efficiency of clinical and support serviceprovided. Ensure that the fabric and structure of the facilityremain fully fit for purpose and being the principle point ofcontact between the facility executive and corporate departmentsensures that external utilities including security, housekeeping,gardening, transport, catering, copy center, laundry and mailservices meet the facilities requirements Key Accountabilities· Designs, updates and implements policies, proceduresand protocols to ensure efficiency and accuracy in insuranceoperations. · Conduct weekly departmental meetings withstaff for updates and to educate them on new work methods· Ensure that insurance claims are processed in a timelymanner and resolve issues that arise during process. ·Follow up and negotiate with Insurance Companies where needed toensure approval of problematic cases. · Overseeadministration of medical services to Insurance and Corporatepatients or/and customers of the Hospital. · Liaise withinsurance companies regarding eligibility, payments, reconciliationand other requirements. Organize training session for concernedemployees to develop their understanding of insurance policies andcondition. · Review insurance claims to ensure accuracyas per agreement, prior to dispatch to respective insurancecompanies. ·Proactively report critical issues toManagement and submit monthly aging and other reports to linemanager · Responsible for following up and monitoringthe collection of all receivables. · Monitor insurancediscounts, rejections and prepare & submit periodic reportsto the line manager for review. · Ensure that theinsurance schemes are up to date on the system. ·Attending and organizing the insurance presentation internally andexternally. · Provide the necessary guidance and on-jobcoaching and in-service training for the staff under directsupervision. · Assume new responsibilities as and whenneeded. · Prepare all statistics required by Managementincluding Claim cost, Average Claim Ratio etc. Essential JobRequirements Education Any Bachelor'sDegree