Assistant Manager - Approval Center Doctor
EFU Life Assurance Ltd.
Published Date: • Karachi, Pakistan (On-Site)
Description
The ideal candidate holds an MBBS degree and possesses a solid understanding of treatment protocols and medical ethics. Candidates with an MBA in Healthcare Management will be preferred. This opportunity is open to both fresh graduates and experienced professionals who are interested in transitioning to or advancing within the non-clinical healthcare domain. Effective communication and analytical capabilities are essential to succeed in this dynamic role. By joining EFU Life Assurance Ltd., you will contribute to maintaining high standards in medical case evaluations while supporting the company’s mission to deliver quality healthcare services and insurance solutions.
Responsibilities
- Review and analyze medical cases submitted for approval, ensuring adherence to company policies and clinical guidelines.
- Evaluate treatment plans, diagnostic reports, and requests for hospitalization to verify their medical necessity and fairness.
- Apply expertise in medical ethics and insurance medical guidelines when making approval decisions.
- Conduct thorough medical record analysis, including diagnostic coding using ICD-10 and CPT standards, to support accurate case evaluations.
- Ensure compliance with all relevant regulatory requirements and internal standards in every medical assessment.
- Collaborate with hospitals, panel doctors, and internal teams to clarify case details and obtain additional information as needed.
- Maintain comprehensive and accurate medical documentation for all cases reviewed to support transparency and audit readiness.
- Stay updated on current medical best practices, healthcare policies, and emerging clinical guidelines to enhance decision-making quality.
- Participate in continuous learning and professional development activities to improve clinical evaluation skills.
- Support the enhancement of medical review processes by providing feedback and recommendations based on case reviews.
Experience
2 Years
Apply By
Required Skills
- Medical Evaluation
- Clinical Decision Making
- Insurance Medical Guidelines
- Medical Documentation
- Medical ethics
- Medical record analysis
- Diagnostic Coding (ICD-10, CPT)
- Medical Coding
- MBBS