About this role
GENERAL DESCRIPTION
• To plan and carryout duties in related to Insurance / MCO guarantee letters and queries in providing excellent quality management and continuous improvement and development in line with hospital objectives.
JOB DESCRIPTION MCO Functions
• Responsible to ensure all insurance forms are filled up completely by Admitting Consultants and patient before fax or upload into portal for requesting Initial or Final Guarantee Letter. • Responsible to fax or upload into online portal a copy of bills and medical reports to Insurance/ MCO companies for issuance of Final Guarantee Letter. • To ensure that patients being informed immediately on the feedback from insurance companies and attend to their queries. • Immediately update patient and Consultant on the decline of guarantee letter and informing patient to pay a top up deposit as per cash paying patient. • To coordinate with Billing Unit and Ward on the feedback from insurance company to facilitate the discharge procedure for patients. • To follow up with Consultants on medical report not completed in time. • Responsible to respond to all queries made by Insurance/ MCO Companies on timely manner. • Immediately requesting any top up Guarantee Letter either for Inpatient or Outpatient. • To ensure all patients payee code are converted once received initial guarantee letter. • Responsible to ensure the GL Validity are updated into Hits. • To coordinate with Credit Control Unit on submission of bills to insurance companies and collection. • To assist any representatives from Insurance/MCO on the visit of their clients in ward. • To ensure all Insurance / MCO portal are refresh for every 10 minutes.
Billing Functions
• To check on the final bill before fax or upload into the online portal for the final guarantee letter. • Responsible to fax or upload immediately into the online portal on the amendment of final bill.
OSH Act & Regulations 1994
• Responsible and accountable to carry out duties as employee stipulated in OSH Act & Regulations 1994. • To take reasonable to carry at work for the safety of yourself and other persons. • To co-operate with your employer or any other person in the discharge of any duty. • To were or use any protective equipment or clothing provided by the employer. • To comply with any instruction and measure on occupational safety and health.
Patient Safety Goal
• Ensure compliance of Patient Safety Goals as safety improvement measures as recommended by World Alliance for Patient Safety. • Ensure the policies on Patient and Family’s Rights are addressed at all times.
Integrated Management System
• Participates actively and encourages compliance to all policies and Procedures of ISO 9001:2015, OHSAS 18001, ISO 14001:2015, ISO 45001:2018, ISO 37001: 2016, Malaysian Hospital Accreditation Standards and PSG.
PDPA Act 2010
• To review and adopt internal personal data protection policies and practices to comply with the PDPA Act 2010.
Participate actively in any other new service that is introduced
• Ensure produce better result and Continual Improvement in deliver service to customers.
To perform any others duties as and when required by the management
• Produce outcome within the expectation of the shareholder and customers.
JOB REQUIREMENTS
• Minimum qualification of SPM. • Diploma from recognized university. • Good interpersonal, pleasant appearance, good written communication skill as well as fluent in both spoken and written in Bahasa and English. • IT literate with knowledge in Microsoft Office. • 3 years experience in related fields. • Good interpersonal, pleasant appearance, good written and communication skill as well as fluent in both spoken and written Bahasa, English and Mandarin. • IT literate and proficient in Microsoft Office. • Willing to work extra hours i.e. after office hours, on weekends and public holidays (whenever required).
PERSONAL CHARACTERISTICS
• Good in communication and managing skills. • Possess excellent decision-making, strategic thinking, leadership, interpersonal and ethical conduct skills.