Pre-certification Officer 医疗保险审核专员-上海-00026
上海和睦家医院有限公司
- 公司规模：1000-5000人
- 公司性质：合资(欧美)
- 公司行业：医疗/护理/卫生
职位信息
- 发布日期：2013-12-28
- 工作地点：上海
- 招聘人数：若干
- 工作经验：二年以上
- 学历要求：大专
- 语言要求：英语熟练
普通话熟练 - 职位类别：保险核保
职位描述
Position: Pre-certification Officer 医疗保险审核专员
Job Summary
1. Direct Billing and insurance benefit verification
2. Responsible for ensuring the timely and accurate review of any situation requiring a medical determination prior to final payment
Responsibilities
1. Direct Billing eligibility and insurance policy benefit verification
2. Support Dental clinic on insurance verification and coverage seeking
3. Estimated cost calculation according to treatment plans and hospital’s pricing principle
4. Communicates with patients about their payment method, clearly discussion of the deposit / guarantee status and payment plans
5. Communicates and convince third party payers to obtain payment guarantee
6. Update insurance companies about insured patient’s costs and make sure the expenses are covered by a guarantee letter
7. Provide the insurance company with information required
8. Prepare inpatient census on daily basis
9. Take charge of maternity payment management as assigned, which includes but not limited to accomplish monthly delivery plan, maternity package recording, maternity payment discussion initiation during patients’ first few prenatal visits, etc
10. Provide financial counseling service to patient
11. Support supervisor and managers on case study to propose appropriate payment solution for any special cases
12. Clearly communication and sell package to qualified patient
13. Introduce membership program to qualified patient
14. Other assignments by supervisor or managers
Qualifications and Skills
1. Associate college degree required
2. Customer service experience, at healthcare business preferred
3. Fluent in Chinese and English
4. Familiar with Microsoft office tools
5. Able to approach staff, co-workers, and supervisors
6. Able to “sell” hospital services to convince payers
7. Must work well under pressure and be able to work on multiple tasks simultaneously
8. Good understanding of healthcare business
9. Knowledge of medical terminology and insurance industry preferred
15. Knowledge of customer service
Job Summary
1. Direct Billing and insurance benefit verification
2. Responsible for ensuring the timely and accurate review of any situation requiring a medical determination prior to final payment
Responsibilities
1. Direct Billing eligibility and insurance policy benefit verification
2. Support Dental clinic on insurance verification and coverage seeking
3. Estimated cost calculation according to treatment plans and hospital’s pricing principle
4. Communicates with patients about their payment method, clearly discussion of the deposit / guarantee status and payment plans
5. Communicates and convince third party payers to obtain payment guarantee
6. Update insurance companies about insured patient’s costs and make sure the expenses are covered by a guarantee letter
7. Provide the insurance company with information required
8. Prepare inpatient census on daily basis
9. Take charge of maternity payment management as assigned, which includes but not limited to accomplish monthly delivery plan, maternity package recording, maternity payment discussion initiation during patients’ first few prenatal visits, etc
10. Provide financial counseling service to patient
11. Support supervisor and managers on case study to propose appropriate payment solution for any special cases
12. Clearly communication and sell package to qualified patient
13. Introduce membership program to qualified patient
14. Other assignments by supervisor or managers
Qualifications and Skills
1. Associate college degree required
2. Customer service experience, at healthcare business preferred
3. Fluent in Chinese and English
4. Familiar with Microsoft office tools
5. Able to approach staff, co-workers, and supervisors
6. Able to “sell” hospital services to convince payers
7. Must work well under pressure and be able to work on multiple tasks simultaneously
8. Good understanding of healthcare business
9. Knowledge of medical terminology and insurance industry preferred
15. Knowledge of customer service
公司介绍
上海和睦家医院于2004年12月1日开始营业。上海和睦家医院的宗旨是：在家庭般温馨舒适的就诊环境里，为患者提供全方位的医疗服务。
上海和睦家医院具有自己特定的建院目的，是一家获得JCI国际认证的综合性医院，拥有来自全球的高水平医务人员，同时可与全球40多家保险公司直接结算。上海和睦家医院设有24小时开放的急诊室，可为患者提供门诊和住院服务，医院还配备有手术室、放射科、药房和化验室。
上海和睦家医院在选择具有国际背景的医生和本地医疗专家时，不仅考察其培训经历和专业知识是否卓越，还要考察他们的同情心、同理心以及是否真正有兴趣在多元文化环境中工作。除了具有高水平的医疗团队外，上海和睦家医院还与来自地方教学医院及亚洲地区医疗机构的医学教授和顾问建立了良好的工作关系。
上海和睦家医院是值得您信赖的健康伙伴！
地址：上海市长宁区平塘路699号 邮编：200336
官网：**************************/
上海和睦家医院具有自己特定的建院目的，是一家获得JCI国际认证的综合性医院，拥有来自全球的高水平医务人员，同时可与全球40多家保险公司直接结算。上海和睦家医院设有24小时开放的急诊室，可为患者提供门诊和住院服务，医院还配备有手术室、放射科、药房和化验室。
上海和睦家医院在选择具有国际背景的医生和本地医疗专家时，不仅考察其培训经历和专业知识是否卓越，还要考察他们的同情心、同理心以及是否真正有兴趣在多元文化环境中工作。除了具有高水平的医疗团队外，上海和睦家医院还与来自地方教学医院及亚洲地区医疗机构的医学教授和顾问建立了良好的工作关系。
上海和睦家医院是值得您信赖的健康伙伴！
地址：上海市长宁区平塘路699号 邮编：200336
官网：**************************/
联系方式
- 公司地址：上海市长宁区平塘路699号 邮编：200336