Medical Doctor (Preapproval)

dnata Travel Group; Philippines; On-site; PHP 600,000 - 800,000; Full time

Job summary

dnata Travel Group is seeking a Pre-Approval Doctor for the Medical Benefits team in Clark, Pampanga. You will issue pre-approvals to medical providers, confirm cover based on member eligibility and contract terms, and manage telephone and system approvals.

The role requires a Medical Degree and current Philippine license, with preferred experience in medical insurance and at least 2 years post-qualification in ER, GP, or Family Medicine.

Qualifications

• Medical Degree from a recognised university.
• Current License to practice in the Philippines.
• Experience working in a medical insurance field is preferred.
• 2 years post qualification experience, preferably in Emergency Room, General Practice or Family Medicine.
• Computer literate, Proficiency in the MS Office Suite of Software. (Excel/Word/Power Point)
• Proficiency in written and spoken English.

Responsibilities

• Action pre-approval transactions from contracted medical providers in line with agreed operating procedures and service level agreements
• Use medical training, knowledge and departmental guidelines to ensure accurate assessment of pre-approvals
• Ensure consistent application and review of treatment plans to ensure cover in line with contracted pricing
• Complete system and written administration in line with audit requirements and ensure approvals are documented in correct detail to support smooth claims administration.
• Complete activities in line with service agreements while demonstrating ability to prioritise according to medical urgency
• Ensure correct reference to policy of all communication whether verbal or in writing
• Respond to call centre phone queries/ online chat function related to coverage queries and claims in line with published protocols.

Skills

MS Office

English proficiency

Education

Medical degree

Philippines medical license

Job description

dnata is the largest travel management organisation in the Middle East, with over 50 years of experience in the industry. Over the years, we have established successful partnerships with a range of first-class service providers, in order to offer you the best travel products in the world. Our Services range from Retail, Business, and Airline General Sales Agent Services and Destination Management.

The Pre-Approval Doctor- Medical Benefits will work within the Medical Benefits team and will be responsible for issuance of pre-approvals to medical providers for specific services mentioned in the contractual SOP. The role holder will manage telephone and system approvals and be responsible for confirming cover based on member's eligibility, scheme terms and utilisation history.

• Applicants must be willing to work and relocate to Clark, Pampanga.
• Medical Degree from a recognised university
• Current License to practice in the Philippines
• Experience working in a medical insurance field is preferred
• 2 years post qualification experience, preferably in Emergency Room, General Practice or Family Medicine
• Computer literate, Proficiency in the MS Office Suite of Software. (Excel/Word/Power Point)
• Proficiency in written and spoken English.

Key Responsibilities and Accountabilities

• Action pre-approval transactions from contracted medical providers in line with agreed operating procedures and service level agreements
• Use medical training, knowledge and departmental guidelines to ensure accurate assessment of pre-approvals
• Ensure consistent application and review of treatment plans to ensure cover in line with contracted pricing
• Complete system and written administration in line with audit requirements and ensure approvals are documented in correct detail to support smooth claims administration.
• Complete activities in line with service agreements while demonstrating ability to prioritise according to medical urgency
• Ensure correct reference to policy of all communication whether verbal or in writing
• Respond to call centre phone queries/ online chat function related to coverage queries and claims in line with published protocols.