Referral Approving D....
Referral Approving Doctor
Posted on :
17-04-2024
Employer Active
1 Vacancy
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Job Description
Req ID : 564355
- Answer inbound calls as well as assist parties who have specific inquiries.
- Queries may range between coverage questions, network location and medical questions.
- Receive, evaluate and assess approval requests from Healthcare providers (Hospitals, Laboratories, pharmacies…)
- Insure that all needed required documentation (referral form, completed medical reports, related investigation results) are in order.
- Review all referred cases to determine completeness of documentation, accuracy of the differential diagnosis and take most appropriate and timely recommendation and action
- Participate in committees, work groups, and/or process improvement teams that improve patient satisfaction.
- Review all medical approvals & claims.
- Issuance of necessary medicines and medical approvals - surgeries - X-rays - tests that require it
- Medical solving customer problems.
- For all non-urgent cases review the need for referral and admission if requested
- Be the lead and responsible key person to communicate and negotiate with the external hospital, medical facility or treating doctor
Employment Type
Full Time
Company Industry
Department / Functional Area
Doctor / Nurse / Paramedics / Hospital Technicians / Medical Research
Key Skills
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