Overview

Approval Doctor / Pre-Authorisation Doctor Job in Saudi Arabia at Bupa Arabia

Job Description

In this role you will support Bupa to ensure medical spend (In-Patient & Out-Patient services) is controlled by ensuring that pre-authorisation decisions are within defined SAMA & CCHI regulations, accepted guidelines and high quality medical standards, safeguarding the member’s health & safety and aligned to BUPA Values.

You will be responsible for the following:

– Medial cost & Service Management: Adjudicate the cases (In-Patient & Out-Patient) based on common medical practice and in line with Bupa protocols and policy. Ensure the decisions are according to the best medical standards and agreement terms & conditions in order to prevent abuse, fraud and overtreatment.

– High quality medical decision & patient safety: Ensure working with high quality of decision making with Zero QDI (Quality Demerit Index) A or B. Ensure the medical decisions are consistent and are implemented based on clinical and practice guidelines signed off by the organization. Ensure high customer satisfaction in line with BUPA values and business strategy.

– Efficiency management: Ensure achieving the daily targets in terms of productivity & speed of response.

– Ensure proper interpretation and usage of clinical skills.

– Compliance to policy and Regulation: Report all high value claims as per agreed process.

– Highlight and report fraud, abuse, and anti-selection.

Skills

– Bachelor’s degree or post graduate degree in medical majors,

– Minimum 2 years’ experience.

– Ability to conduct business in English language.

– Ability to work under pressure.

– Strong communication skills.

– Clinical experience in general practitioner or Emergency or Family Medicine.

Job Details

Job Location
Saudi Arabia

Company Industry
Other Business Support Services

Company Type
Employer (Private Sector)

Job Role
Medical, Healthcare, and Nursing

Employment Type
Full Time Employee

Monthly Salary Range
Unspecified

Number of Vacancies
7

Preferred Candidate

Career Level
Mid Career

Years of Experience
Min: 2 Max: 5

Residence Location
Saudi Arabia

Gender
Male

Degree
Bachelor’s degree / higher diploma

About Company

Company: Bupa Arabia

Company Location:  Saudi Arabia

Job Category: Other Business Support Services

About Bupa Arabia