For a leading chain of iVein Clinics in Egypt, we are hiring for a position of “Medical Approval Desk” for our Office branch in Alexandria. We are looking for an medical approval desk to evaluate and process requests for medical treatments, procedures, and claims to ensure compliance with insurance policies, medical guidelines, and organizational protocols. This role involves reviewing medical documentation, coordinating with healthcare providers, and making informed decisions on approvals.
Key Responsibilities:
- Review and assess requests for medical treatments, procedures, and claims.
- Verify the accuracy and completeness of medical documentation and supporting information.
- Ensure that requests comply with relevant medical guidelines, insurance policies, and regulatory requirements.
- Stay updated on changes in medical policies, guidelines, and industry standards.
- Communicate with healthcare providers, insurance companies, and patients to gather necessary information and clarify details.
- Provide clear explanations and justifications for approval or denial decisions.
- Make informed decisions regarding the approval or denial of requests based on medical necessity and policy criteria.
- Document and record decisions and actions taken in the approval process.
- Work closely with medical staff, insurance representatives, and administrative personnel to facilitate the approval process.
- Coordinate with other departments to resolve any issues or discrepancies related to approvals.
- Maintain accurate and up-to-date records of all requests, decisions, and communications.
- Prepare reports and summaries as required for management review.
- Provide excellent customer service to patients and healthcare providers by addressing inquiries and resolving issues related to the approval process.
- Assist in navigating complex situations and ensuring a smooth approval experience.
- Participate in quality assurance activities to ensure the accuracy and effectiveness of the approval process.
- Recommend improvements to procedures and practices to enhance efficiency and compliance.
Bachelor’s degree in healthcare administration or a related field; or equivalent work experience.Previous experience in medical approvals, healthcare administration, or a related field preferred.Strong understanding of medical terminology, insurance policies, and regulatory requirements.Excellent analytical and decision-making skills.Effective communication and interpersonal skills.Detail-oriented with strong organizational abilities.Proficiency in relevant software and systems (e.g., electronic health records, insurance claim systems).Proven work experience, Front Office Representative or similar roleProficiency in Microsoft OfficeHands-on experience with office equipment (e.g. fax machines and printers)Professional attitude and appearanceSolid written and verbal communication skillsAbility to be resourceful and proactive when issues ariseExcellent organizational skillsMultitasking and time-management skills, with the ability to prioritize tasksCustomer service attitude