dnata is the largest travel management organisation in the Middle East, with over 50 years of experience in the industry. Over the years, we have established successful partnerships with a range of first-class service providers, in order to offer you the best travel products in the world. Our Services range from Retail, Business, and Airline General Sales Agent Services and Destination Management.
Job Purpose:
The Pre-Approval Coordinator - Medical Benefits will work within the Medical Benefits team and will be responsible for issuance of pre-approvals to medical providers for specific services mentioned in the contractual SOP. The role holder will manage telephone and system approvals and be responsible for confirming cover based on member's eligibility, scheme terms and utilisation history.
Minimum requirements:
- Applicants must be willing to work and relocate to Clark, Pampanga
- Applicants must be a Filipino citizen or have a relevant residence status
- Bachelor's Degree in a relevant nursing and allied medicine field
- Minimum of 3 years work experience in a medical insurance field is preferred, but not required
- Minimum of 2 years clinical medical experience is an advantage
- Proficiency in Microsoft Word, Excel, and Outlook required.
- Proficiency in written and spoken English.
- Must be keen to details and problem solving skills.
- Must be willing to work on shifting schedule.
- Must be willing to work on holidays and weekends.
Key Responsibilities and Accountabilities
- Action pre-approval transactions from contracted medical providers in line with agreed operating procedures and service level agreements
- Use medical training, knowledge and departmental guidelines to ensure accurate assessment of pre-approvals
- Ensure consistent application and review of treatment plans to ensure cover in line with contracted pricing
- Complete system and written administration in line with audit requirements and ensure approvals are documented in correct detail to support smooth claims administration.
- Complete activities in line with service agreements while demonstrating ability to prioritise according to medical urgency
- Ensure correct reference to policy of all communication whether verbal or in writing
- Respond to call centre phone queries/ online chat function related to coverage queries and claims in line with published protocols.
