Assistant Manager Medical Evaluation (Case Management)  
Adamjee Insurance Company Limited   More jobs from this company

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Job Title:   Assistant Manager Medical Evaluation (Case Management)
Category:   Health & Medicine
Total Positions:   1
Job Location:   Islamabad
Gender:   No Preference
Minimum Education:   MBBS
Career Level:   Experienced Professional
Minimum Experience:   1 Year year(s)
Apply By:   Dec 28, 2019
Job Description:
  • Medical Management: To have close contact with network hospitals for pre-authorizations of hospital admissions as per the medical necessity & policy document.
  • Hospital Management: Review of existing panel facilities to negotiate rate revisions for cost effective credit arrangements
  • Responsible to monitor daily hospital admissions & determine the necessity and appropriateness of the treatment and continued inpatient care during patient’s hospitalization.
  • Timely authorization for admission to panel hospitals in accordance with the policy document.
  • Responsible to handle company hotline.
  • To coordinate with clients for facilitation of hospitalization in panel hospitals as per policy terms.
  • To visit network hospitals to strengthen relationship with the service providers and rate negotiations.
  • To visit non panel facilities (panel hospital/discount center) to enlist them on our panel as per hospital evaluation criteria to increase panel network.
  • To coordinate with policy and claim departments for all queries related to endorsements/ hospital outstanding claims, respectively.
  • To arrange and give orientation sessions to clients related to policy coverage & clinical presentations related to wellness program on need basis.

Required Skills:
MEDICAL CLAIMS,Medical Case Management,Hospital Reimbursement

Company Information
Company Name:  Adamjee Insurance Company Limited
Company Description:

pAdamjee Insurance Company Limited (AICL) was incorporated as a Public Limited Company on September 28, 1960 and is listed on all three stock exchange of Pakistan. The Company is also registered with the Central Depository Company of Pakistan Limited (CDC) and is involved in the business of general insurance. The head office is located in Karachi and it operates a network of branches all across Pakistan and two in UAE (Dubai & Abu Dhabi). The Company commenced operations with a paid-up capital of Rupees 2.5 million, which has grown phenomenally in the past five decades to Rupees 1.24 billion, as on 31 December 2012. A strong asset base, significant paid-up capital, substantial reserves, balanced portfolio mix along with steady growth in gross premium account gives Adamjee Insurance a well deserved competitive edge within the insurance industry./p

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