PURPOSE:
Responsible for accurate capture of inpatient undertakings, authorization, cost control and hospital length of stay management.
PRIMARY RESPONSIBILITIES:
Monitor inpatient authorizations and admission undertakings;
Monitor cost control, average length of stay on inpatient authorizations;
Pre-authorize optical and scheduled cases;
Coordinate medical care monthly Rota and duty allocation and ensure conformity to rota and assigned duties/coverage;
Respond to client, provider and contact person queries on cases involving medical care management;
Receive and respond to Medical emergency lines and ensure 24-hour coverage and
Negotiate for discounts from doctors on specific cases and procedures as they arise.
GENERIC DUTIES
Carry out performance appraisal, coaching and mentoring staff;
Participate in planning and budgeting for the department.
PERSON SPECIFICATIONS
Academic Qualifications
Bachelor’s degree in Health System Management, Nursing or in a related field
Professional Qualifications
COP-Insurance is an added advantage
Experience
Up to three (3) years’ relevant experience
Skills and Attributes
Problem solving skills;
Good analytical skills;
Computer literate in MS Office and other office applications;
Understanding of the working environment /competitors;
Technical competence in insurance;
Basic knowledge of regulations by AKI and IRA;
High emotional intelligence;
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