Health Facilitator Officer – Insurance Company
Prime Human Resource Services (Pvt) Ltd
PKR 54,000 • Published Date: • Multiple Cities (On-Site)
Description
Prime Human Resource Services (Pvt) Ltd is seeking a diligent Health Facilitator Officer to support the coordination of healthcare services for insured members within the insurance sector. The ideal candidate holds a bachelor's degree in Healthcare, Business Administration, or a related field and brings between one to three years of experience in health insurance, third-party administration, hospital coordination, or medical claims. This role requires close collaboration with hospitals and healthcare providers to facilitate pre-authorizations, claims processing, and ensuring timely resolution of pending cases. The position demands strong communication, coordination, and proactive follow-up skills to deliver exceptional customer support. In this role, you will manage intricate customer queries related to health insurance benefits and coverage while maintaining accurate records. Additionally, you will coordinate effectively with internal medical and claims teams and assist with medical documentation to ensure compliance and operational efficiency. Proficiency in Microsoft Office tools is essential to maintaining precise and organized data management. This position does not involve managing a team but requires self-motivated and detail-oriented work ethic to excel in a fast-paced insurance environment.
Responsibilities
- Coordinate healthcare services and medical benefits for insured members to ensure smooth processing and approvals.
- Respond promptly and accurately to customer queries regarding health insurance benefits, coverage options, and claims status.
- Act as a liaison with hospitals and healthcare providers to secure necessary approvals, pre-authorizations, and required documentation.
- Assist in claims processing activities by reviewing medical documentation and supporting timely claims submission.
- Maintain up-to-date and accurate customer data and case records within internal management systems.
- Collaborate closely with internal teams including medical and claims departments to follow up on pending cases and expedite resolutions.
- Ensure compliance with healthcare regulations and company policies in all customer and provider interactions.
- Utilize Microsoft Office applications effectively to document, track cases, and generate reports to support operational activities.
- Monitor healthcare claims lifecycle from initiation to closure to enhance customer satisfaction and operational effectiveness.
- Continuously improve knowledge of health insurance products, medical terminology, and healthcare compliance standards.
Cities
Kotli Loharan, Pakistan | Skardu, Pakistan | Kotli, Pakistan | Gilgit Baltistan, Pakistan (On-Site)
Experience
1 Year
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Required Skills
- Communication
- Coordination
- Follow-up
- Microsoft Office
Nice to Have Skills
- Health Insurance Knowledge
- Medical Terminology
- Customer Relationship Management
- Claims Processing
- Healthcare Compliance
- Customer Data Management
- Insurance Claims Processing