Senior Patient Admin Executive

Role Overview

Senior Patient Admin Executive at NMC Healthcare. Location not specified in source.

Role Purpose

Manage patient reception, registration, insurance verification, billing, and cash processing while leading the administrative team to ensure smooth operations, regulatory compliance, and high-quality patient service across all touchpoints.

Key Responsibilities

Patient Reception & Registration

• Greet patients and clients and confirm the nature of visits.
• Direct patients to appropriate individuals or departments.
• Provide routine information about the hospital when necessary.
• Register new patients and follow up with existing patients by collecting and updating patient details.
• Cater to the needs of all incoming patients with or without appointments.
• Maintain working knowledge of the Hospital Information System, times of all clinics, duration of appointments, doctor's duty roster, and procedure for booking appointments.

Phone & Communication Management

• Handle phone inquiries from patients and others.
• Screen calls to ascertain nature and urgency of inquiry.
• Refer callers as appropriate or schedule appointments.
• Provide information to respective doctors or nurses for call backs.
• Check emails daily, reply where required, and clear respective dues if any.

Insurance & Billing Management

• Provide information about medical insurance coverage to patients.
• Check insurance coverage diligently before sending patients to the doctor.
• Ensure payor eligibility verification.
• Collect payment and co-payments after checking insurance eligibility.
• Enter collected payments on the hospital information system.
• Respond to inquiries from patients regarding treatment, benefits, and billings.
• Coordinate resolution of related problems.
• Provide claim forms for patients seeking reimbursement.
• Generate and process patient invoices for services rendered, including consultations, treatments, and diagnostic tests.
• Ensure that all charges are accurately recorded in the patient's account, reflecting correct services, dates, and codes.
• Issue bills and invoices to patients for any outstanding balances, including co-pays, deductibles, or non-covered services.
• Provide patients with detailed statements and assistance in understanding their charges and payment options.
• Collect co-pays, deductibles, and outstanding balances at the time of service.
• Investigate billing discrepancies by reviewing patient records, insurance information, and charges to identify errors.
• Track outstanding bills and provide regular updates to management regarding billing performance and collections progress.
• Ensure billing practices comply with legal and insurance requirements.

Cash & Financial Processing

• Facilitate daily cash collection, credit card slips, and cheques deposits at designated locations within hospital premises.
• Ensure timely and accurate processing at the end of each shift.
• Adhere to finance protocols standards.

Team Lead & Operational Duties

• Monitor employee scheduling of the department to ensure operational coverage.
• Provide support related to attendance, leave, overtime, staff allocations, uniform, dress code, and personal hygiene.
• Ensure operations are carried out uniformly according to hospital policies and procedures.
• Maintain safe and clean reception area by complying with procedures, rules, and regulations.
• Contribute to team effort by accomplishing related results as needed.
• Exercise effective interpersonal skills in dealings with department staff, colleagues, and management.

Quality & Compliance

• Participate in hospital training programs.
• Handle complaints in a structured, timely, and professional manner that is fair, courteous, and respectful of privacy.
• Identify problems and continuously improve the department's services.
• Maintain quality service by ensuring quality customer service standards, identifying trends, and recommending process improvements.
• Support Continuous Quality Improvement and participate in all quality assurance activities of the service.
• Strictly adhere to NMC's regulations and policies, especially those related to infection control, patient safety, and JCI.
• Maintain patient and staff confidentiality.
• Maintain high standards of data accuracy while ensuring compliance with privacy regulations.
• Follow the duty schedule as assigned by supervisor, which includes different shift timings as per department needs.

Qualifications & Experience

• 2+ years of experience in a customer service role or relevant field.
• Healthcare experience in UAE is an advantage.