Medical insurance director
2 weeks ago
The Medical Insurance Director will oversee and manage all aspects of the hospital's medical insurance operations, including claims processing, negotiations with insurance companies, and financial collections. This role requires a strategic thinker with strong leadership skills and extensive experience in medical insurance and claims management. The successful candidate will ensure efficient and effective insurance claim operations, optimizing revenue cycles and maintaining compliance with regulatory requirements.
Oversee the entire medical claims process, ensuring timely and accurate submission of claims.
Monitor and manage claims status, identifying and addressing any delays or issues in processing.
Develop and implement strategies to minimize claim denials and optimize reimbursement.
Negotiate contracts and agreements with insurance companies to secure favorable terms and conditions for the hospital.
Establish and maintain strong relationships with insurance providers to facilitate smooth operations and conflict resolution.
Analyze and interpret insurance policies, guidelines, and regulations to ensure compliance and maximize benefits.
Develop and implement effective strategies for the collection of outstanding claims and overdue payments.
Collaborate with the finance department to reconcile accounts and ensure accurate financial reporting.
Monitor and report on key performance indicators related to collections and claim management.
Lead the insurance claims team, providing guidance, training, and performance evaluations.
Foster a positive and productive work environment, encouraging teamwork and continuous improvement.
Develop and implement policies and procedures to enhance operational efficiency and effectiveness.
Prepare and present regular reports to senior management on the status of claims, collections, and overall performance.
Qualifications:
Bachelor's degree in Business Administration, Healthcare Management, Finance, or a related field. Master's degree preferred.
Minimum of 10 years of experience in medical insurance and claims management, with at least 4 years in a leadership role.
In-depth knowledge of medical insurance policies, claims processes, and regulatory requirements in Qatar.
Proven track record of successful negotiations with insurance companies and financial collections.
Strong analytical, problem-solving, and decision-making skills.
Excellent communication and interpersonal skills, with the ability to build and maintain relationships.
High level of integrity, professionalism, and attention to detail.
Job Types: Full-time, Permanent
Pay: From QAR15,000.00 per month
Experience:
- medical insurance: 6 years (Required)
Language:
- English (Required)
Application Deadline: 30/06/2024
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