• Review the discharge billing process and ensure financial clearance was performed as per best practice and as per agreed KPIs.
• Ensure process in place to verifying the patient data.
• Verifying HIC, scheme &policy.
• Validating the DOA &DOD and level of Accommodation for (IP claims only)
• Validating the current available approvals & provided services matching.
• Verifying Assigned Physician (External or not)
• Check the invoice components: (Medical services, Surgical (PKG & Itemized), Pre-Operative investigations, Medical Supplies)
• Verifying the missed documents (OR notes, Discharge summary).
• Open the original invoice& preparing it for Balancing
• Apply PKD if any, Apply Room Difference if any.
• Apply itemized services ifany.
• Identifying the provided services either (included / excluded) from PKGs
• Demonstrates compassionate-communication skills while providing support and care to the patients as “the patient is the center of our care”.
• Follow up with pre-authteam for pending approval
• Follow with OR team for missing charges and related issues
• Monthly final review of discharged cases
• Coordinating with finance for all required queries and assistance
• Coordinating with other RCM units (technical rectification, Patient access, billing & contracting) for required support
• Coordinating with HIS team for system related requirements
• Perform all duties and tasks in line with the Person Centered Care values.
• Adherence to all policies,plans and programs within the Fakeeh Care.
• Perform duties as per the code of conduct requirement and ethical standards as outlined in the HCM policies and guidelines.
• Complete mandatory education as per the requirement at least one month prior to expiration.
• Maintain up to date knowledge on information relating to quality and safety, accreditation, policy management and document management systems.
• Excellent Communication Skills
• Able to Recognize and accept ownership and propose solution
• Tackles problems in professional manner and develops measures prevent problems
