CV extract as (Medical Doctor and Medical Insurance Manager)

Overall responsibilities as Medical Insurance Manager

 

Claims management, processing and reconciliation:

 

a) Ensure complete and accurate filling of medical claims for submission to various

    insurance companies based locally and abroad.

 

b) Train paramedical hospital staff regarding medical insurance protocols.

 

c) Requisition of prior-authorizations for hospital admission, major diagnostic

    tests and out-patient procedures.

 

d) Coordination and care of insured patients.

 

e) Assist in the development of the hospital software for on-line medical claims      

    processing.

 

Networking with insurances companies and administrators:

 

a) Review, negotiate and prepare contracts between the hospital and the insurance  

    companies and TPA- administrators.

 

b) Business development for all new ventures related to medical insurance.

 

    

c) Timed follow-up for smooth relations between the hospital and the insurance

    company and administrator.

 

 

 Marketing:

 

 a) Propose activities aimed to promote the healthcare facilities in the hospital.

 

 b) Assist in organizing CMEs’ and other related activities.

 

 

Responsibilities during the OPD clinics and In-patient Department between 1300 – 1700 hours:

 

a) History taking and clinical examination.

b) Daily case presentation at the bedside and progress of patients.

c) Devised management plan for the patients, implemented upon Head of Department’s approval.

d) Discharge summaries.

e) Practiced evidence based medicine.

f) Internal Medicine OPD Clinic between 1400-1700 hours under minimum supervision.

g) Worked in multidisciplinary teams.

Appointed Resident in the Dept of Interventional Cardiology for a period of 6 months.

    Worked with Consultant- Physician on stroke management and rehabilitation of patient                   who were referred after a TIA,Mini-stroke or a Stroke and Brain haemorrhage.

 

 

 

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