BUSINESS CENTER OFFICER III

• Greet customers and address queries and requests face-to-face or through the mail, phone, fax and/or email.
• Determine the Patient's eligibility to receive services, whether paid in cash or under financial guarantee, including the collection of the guarantee letters and file in the system. Responsible for opening, updating, changing patient's medical file in compliance to Eligibility guidelines. Ensure that appropriate documentation related to patient identification is uploaded and available in the system.
• Respect and protect patient privacy and dignity at all times and maintain strict confidentiality in conformance to the organizational policy. Advocate for patient/family rights at all times.
• Identify health coverage benefits, co-pays and deductibles and their communication to the patient, in addition to screening admission requests for financial guarantors, co-coordinating with related hospital department services and guarantors or insurance companies.
• Ensure the registration of the contacts with patients under Payer Contact in the Billing System on a daily basis, in addition to opening and monitoring company accounts with Business Center and receiving company requests for treatment of their patients.
• Requisition patients' records, organize registration, subsequent appointments and admission of Business Center patients, screen and refer patients to appropriate specialty and confirm patient attendance for scheduled appointment. Screen Operation Room slot for patient attendance and sufficient financial guarantor, expedite
and complete necessary forms for emergency patients and coordinate with related departments or services in the hospital.
• Provide pro forma invoices to patients using Business Center Billing System and prepare and dispatch approval requests to different companies, prepare necessary documentation to the Insurance Company/Guarantor prior to submitting any invoice. Follow-up with insurance companies the approval request.
• Track utilization of services against paid deposits, and request additional deposit to cover the patients' future needs and to track admissions and discharge patients, and receive and process feedback from guarantors, insurance companies, customers and self-pay patients.
• Assist in the preparation of monthly reports of Business Center activities at the regional level. Participate in implementing continuous quality improvement program in the Business Center. Maintain all records related to area of work and prepare standard and ad hoc reports. Adhere to both hospital policies and governmental regulations concerning the department including the CHI regulations and policies.
• Perform other job related duties.

Competencies I

*Knowledge of Principals and fundamentals of customer service, health administration and health insurance
* Effective communication skills - must be approachable sincere and proactive speaker
* Ability to apply general rules to specific problems to produce answers that make sense

English Language | Essential

Computer : Level II – Essential

• Area specific equipment, tools, software
• Health information system, Billing System
• Council of Health Insurance – CHI; National Platform for Health and Insurance Exchange Services – NPHIES; Insurance Companies’ websites
• Relevant internal and external stakeholders
• Patients/their family members
• Expected to use to critical thinking skills to reach objective conclusions
• High paced environment with intense deadlines
• Great deal of details and accuracy
• Multi-cultural environment
• Perpetual interaction with relevant stakeholders
• Coverage during emergencies, disasters, other unplanned unprecedented occasions
• Shift rotation and occasional overtime, on call, weekend, holidays work might be required

Business Administration or any discipline