Health Facilitator Officer - (Insurance)
Prime Human Resource Services (Pvt) Ltd
PKR 54,000 • Published Date: • Multiple Cities (On-Site)
Description
The Health Facilitator Officer is responsible for ensuring smooth communication and coordination between insured members and healthcare providers. The role does not involve managing a team but requires strong organizational skills to maintain accurate records, handle customer queries, and assist with pre-authorizations and claims processing. The officer will work closely with hospitals, medical teams, and claims departments to facilitate timely resolutions of pending cases. Familiarity with health insurance regulations and a good command of MS Office are necessary to excel in this position. This opportunity offers a competitive salary and a chance to contribute to delivering quality healthcare services within the insurance framework.
Responsibilities
- Coordinate healthcare services and approvals for insured members, ensuring compliance with health insurance policies.
- Respond promptly and effectively to customer queries about insurance benefits, coverage, and claim procedures.
- Collaborate with hospitals and healthcare providers to facilitate pre-authorizations, medical services, and claims processing.
- Assist in the preparation, submission, and follow-up of medical claims, ensuring accuracy and completeness of all documentation.
- Maintain detailed and up-to-date records of all cases, approvals, and claims to streamline internal communication and reporting.
- Monitor pending cases vigilantly and coordinate with internal medical and claims teams to ensure timely resolution.
- Support the insurance team by providing accurate data entry and ensuring the integrity of information in related systems.
- Stay informed about health insurance regulations and guidelines to maintain compliance in all operations.
- Utilize MS Office applications to prepare reports, correspondence, and maintain documentation effectively.
- Build and maintain strong working relationships with healthcare providers, internal teams, and insured clients to promote transparency and trust.
Cities
Kotli, Pakistan | Azad Jammu and Kashmir, Pakistan (On-Site)
Experience
3 Years
Apply By
Required Skills
- Claims Processing
- Customer Relationship Management
- Communication Skills
- Data Entry and Accuracy
- Healthcare coordination
- Pre-authorization Management
- Medical Documentation
Nice to Have Skills
- Health Insurance Regulations
- MS Office Proficiency
- Record Keeping
- Problem Solving