Pharmacy Insurance Coordinator Full Time

REPORTS TO:     IN-CHARGE OF OUTPATIENT PHARMACY 

POSITION SUMMARY:

Assists the pharmacists on all Insurance issues and coordinates with internal and external customers and Insurance Companies with direct approval requirements for prescriptions with AHD.

STATEMENT OF VALUES:

An employee of the American Hospital Dubai is expected to promote the mission and philosophy of the hospital by acting in a caring, courteous and confidential manner towards patients, visitors, colleagues and staff by performing their duties and responsibilities according to the expected standards in order to fully meet patient care needs.

DUTIES AND RESPONSIBILITIES:

QUALIFICATIONS:

• Pharmacy diploma or equivalent
• At least two years’ experience in Outpatient Pharmacy field.

PROFESSIONAL EXPERIENCE:

• Recommended experience at least two years’ experience in the field of insurance and eRx authorization process.
• Recommended knowledge of authorisation requirements and other pre-requisites of insurance companies
• Recommended knowledge of coverage of insurance companies and exclusions

• Quality and Accuracy
• Coordination with following appropriate personnel to ensure that all the formalities as agreed with the insurance companies are followed to minimize objections from them and delays in clarifications to the insurance companies:
• Patient Relations
• Nursing
• Physicians
• Monitoring and follow up on prior E- authorization for outpatient/inpatient services.
• Take approval for prescriptions from Outpatient clinics
• Send approval and follow up for E-claim prescriptions
• Monitor approvals from waitlist in Meditech.
• Works under the supervision of the immediate manager
• Monitors the pending list on a daily basis
• Complete knowledge of insurance policies and protocols
• Makes accurate, thorough and appropriate work a priority
• Identify and analyze problems, take action to resolve, apply sound judgment and take responsibility for their resolution
• Inform and influence others by clear, concise expression of ideas and information in verbal and written as appropriate.
• Quantity /Organizational Skills
• E-claims follow-up within 48 hours.
• Complaints feedback to be handled within 24 hours
• Email handling within 24 hours
• Anticipates and sets priorities to support department needs and follow policies and procedures for achieving them.
• Makes accurate, thorough and appropriate work a priority
• Request for out-patient to be send out within the same day
• Performs tasks assigned from time to time.

• Pharmacy diploma or equivalent
• At least two years’ experience in Outpatient Pharmacy field.