Pre-authorization Administrator

2 days ago

Doha, Baladīyat ad Dawḩah, Qatar Sidra Medicine Full time 40,000 - 60,000 per year
Description

JOB SUMMARY:

The Pre-authorization Administrator is a member of the Patient Financial Services Department. This position is responsible for reviewing and validating insurance eligibility, and coordination of prior authorization pre-certifications, authorization, coordination of benefits, and ongoing communications with insurance companies. 

KEY ROLE ACCOUNTABILITIES:

  • Verifies accurate patient demographics & healthplan, confirms eligibility verification and member benefit coverage. 
  • Contacts health insurance Company to determine appropriate prior authorization process. Works closely with clinical teams to obtain and clarify documentation to demonstrate medical necessity when deemed necessary.
  • Maintains a high level of understanding of health insurance companies, provider guidelines, and payer updates. 
  • Responsible for insurance verifications and accurate communications to various stakeholders regarding the insurance coverage.
  • Follows up on and assists in rejections from health insurance companies and take any necessary follow up action.
  • Serves as a liaison between health insurance companies, staff and patients to resolve any concerns and maintain a positive working relationship.
  • Performs urgent requests in a timely manner and escalates issues to Line Manager as deemed necessary. 
  • Updates the system with any actions, comments or issues that is related to pre-authorization (conversations approvals, partial approval, denials or request of additional information, etc.)
  • Maintains proper logs and documentation on assigned requests.
  • Covers on-call shifts as per set monthly schedule and compliant with hospital policies and procedures. 
  • Participates in department meetings and departmental process improvement activities.
  • Maintains confidentiality of all patients and medical/clinical information.
  • Maintains working documents in accordance with internal record keeping standards.
  • Maintains confidentiality at all times.
  • Maintains a professional demeanor and upholds the organizational values at all times.
  • Follows all Hospital related policies and procedures. 
  • Participates in professional development activities when applicable. 
  • Performs other related duties as assigned.
  • Adheres to Sidra's standards as they appear in the Code of Conduct and Conflict of Interest policies
  • Adheres to and promotes Sidra's Values

QUALIFICATIONS, EXPERIENCE AND SKILLS:



ESSENTIAL
PREFERRED

Education
Bachelor's Degree in  Business, Commerce or other related field
Formal revenue cycle, health insurance and/or patient billing training

Experience
2+ years' experience in a related role in a healthcare facility or health insurance company 
Experience in a large healthcare facility

Certification and Licensure

Professional Membership

Job Specific Skills and Abilities
  • Demonstrated organizational and time management skills
  • Demonstrated knowledge of medical insurance and coverage
  • Demonstrated ability to understand medical terminology
  • Demonstrated ability to be flexible and responsiveness to changing workloads
  • Demonstrated skill in Customer Service and effective and tactful communications during stressful situations
  • Excellent interpersonal and communications skills
  • Proficiency with Microsoft Office suite
  • Fluency in written and spoken English and Arabic


Fluency in other languages


  • Pre-authorization Administrator

    2 days ago

    Doha, Baladīyat ad Dawḩah, Qatar Management Solutions International (MSI) Full time 40,000 - 60,000 per year

    LocationDoha, QatarExperience2Job TypeOutsourcingJob DescriptionPosition Title: Preauthorization AdministratorExperience: 2+Required Skills & Abilities:Strong organizational and time management skillsSolid knowledge of medical insurance policies and coverage proceduresAbility to understand and interpret medical terminologyFlexibility and responsiveness in...

  • Patient Administrator

    2 days ago

    Doha, Baladīyat ad Dawḩah, Qatar Management Solutions International (MSI) Full time 120,000 - 240,000 per year

    LocationDoha, QatarExperience5Job TypeOutsourcingJob DescriptionJOB SUMMARYThe Patient Administrator provides excellent patient-focused care while performing accurate and timelyreferral processing, scheduling and registration activities. The Patient Administrator is responsible for keyoperational practices in the delivery of exceptional ambulatory...

  • Pre-Commissioning Lead

    2 days ago

    Doha, Baladīyat ad Dawḩah, Qatar Saipem Full time 85,000 - 116,000 per year

    Saipem is a global leader in the engineering and construction of large-scale projects in the energy and infrastructure sectors, both offshore and onshore. Organized into business lines—Asset Based Services, Drilling, Energy Carriers, Offshore Wind, Sustainable Infrastructures, Robotics & Industrialized Solutions—we are united as "One Company."Guided by...

  • Lead Contract Administrator

    2 days ago

    Doha, Baladīyat ad Dawḩah, Qatar UCC Holding Full time 90,000 - 120,000 per year

    Role OverviewThe Lead Contract Administrator is responsible for managing the full contract lifecycle for large-scale EPC projects, from pre-award activities through post-award administration. The role ensures that all contractual obligations are properly executed, risks are managed, and the project team is supported with expert contractual guidance.Key...

  • SQL Database Administrator

    5 hours ago

    Doha, Baladīyat ad Dawḩah, Qatar PPL Dynamics Full time $60,000 - $120,000 per year

    ResponsibilitiesDatabase administration in Pre-Production & Production environmentsPerformance tuning & making query optimization recommendationsPatching of the Windows Clusters and SQL server instances they hostWorking with Technical and Solutions Architects to design and implement new SQL Server solutions using established design patternsDeploying new...

  • Oracle IDAM Administrator

    2 weeks ago

    Doha, Baladīyat ad Dawḩah, Qatar Vistas Global Full time 120,000 - 180,000 per year

    Job Purpose Summary:TheSenior Developer B – Oracle IDAM Administratoris responsible for the design, implementation, configuration, and administration of Oracle Identity and Access Management (IDAM) solutions. The role involves managing core components such asOracle Identity Manager (OIM),Oracle Access Manager (OAM),Oracle Unified Directory (OUD),Oracle...

  • Procurement & Administration Specialist

    4 hours ago

    Doha, Baladīyat ad Dawḩah, Qatar Firelink Full time $60,000 - $90,000 per year

    Job Title:Procurement & Admin specialist - Fire Protection IndustryLocation: QatarJob Summary:The Procurement & Administration Specialist is responsible for managing end-to-end procurement activities and providing administrative support to ensure smooth project and maintenance operations across Fire Alarm, Fire Fighting, Gas Suppression, and related systems....

  • Construction Contracts Administrator

    5 hours ago

    Doha, Baladīyat ad Dawḩah, Qatar Detailed Talent Consultancy Full time 200,000 - 300,000 per year

    Position : Construction Contracts AdministratorLocation : Doha, QatarNo. of Vacancies : 2Salary : QAR 20,000Employment Type : Full-TimeExperience Level : 3–5 YearsAbout the RoleWe are seeking a detail-oriented and experienced Construction Contracts Administrator to join our team. The ideal candidate will have hands-on experience in drafting, reviewing, and...

  • Coordinator - Patient Imaging

    2 days ago

    Doha, Baladīyat ad Dawḩah, Qatar Management Solutions International (MSI) Full time 90,000 - 120,000 per year

    LocationDoha, QatarExperience2Job TypeOutsourcingJob DescriptionKEY ROLE ACCOUNTABILITIESPerforms consistent quality scheduling of patients to all modalities in Radiology to meet the needs of thepatient and physician.Consistently performs accurate Patient Identification practices, including proper PEARL record searches.Initiates and advocates decisions in...

  • Junior Legal Administrator

    5 hours ago

    Doha, Baladīyat ad Dawḩah, Qatar TMF Group Full time

    We never ask for payment as part of our selection process, and we always contact candidates via our corporate accounts and platforms. If you are approached for payment, this is likely to be fraudulent. Please check to see whether the role you are interested in is posted here, on our website.About TMF Group:TMF Group is a leading provider of administrative...