MOH Speacialist
- المدينة
- الرياض
- نوع العمل
- حضوري
- تاريخ النشر
- 11 أكتوبر 2026
عن الوظيفة
Ensures that credit patient accounts are opened for every out & inpatient receiving care at Dallah Hospital should have an approval, and maintain this al in an orderly timely manner.
Supporting the organization’s revenue cycle objectives through efficient approval and authorization processes Ensuring compliance with payer policies, contractual requirements, and internal procedures Contributing to timely service delivery by preventing approval-related delays Promoting accuracy, accountability, and transparency in approval workflows Safeguarding organizational revenue by minimizing authorization-related denials Enter the UCAF information in HMIS.
اقرأ الوصف كاملاً
Follow up all pending approval request for in-patient & out-patient and assure that company approval is granted for all services. Contact companies who have contracts with the hospital with relation to referral and approval of treatment. Provides information to patient concerning covered services and approval requirements under their company health plan.
Assure that all inpatient hospitalized within the approval limit.
Fully aware and actively implement the departmental policies and procedures, local and international standards or requirements related to the department Actively involves in indicator development, data collection for the department and to measure the performance of the function, process, and outcome.
Whenever required, conducts analysis and interpretation of data/information collected Participate in hospital Safety Management & Risk Management Programs. Actively reports incidents in the system and whenever needed, participates in incident review, and root cause analysis.
Performs any other duties within the range of his/her competence, as directed by the Revenue Cycle Director.
1-3 years of experience in healthcare revenue cycle, insurance approvals, or patient access Strong understanding of insurance authorization processes and payer requirements Experience working with hospital information systems and approval platforms Familiarity with healthcare reimbursement and claim submission processes Experience in a hospital or healthcare provider setting is preferred Practical experience using NPHIES platform for eligibility, pre-authorization, and approvals Strong understanding of CCHI insurance policies, benefit structures, and compliance requirements Experience handling approvals for inpatient, outpatient, and high-cost procedures under CCHI Familiarity with Saudi healthcare insurance regulations and payer contractual requirements achelor’s degree in Health Administration, Business Administration, Healthcare Management, or related field.
Certified Revenue Cycle Representative (CRCR) (Preferred) Certified Healthcare Access Associate (CHAA) (Preferred) Relevant insurance or revenue cycle certifications (Preferred