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Posted 7 days ago

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Senior Medical Approval

CairoOn-siteFull-time

AI Summary

Reviews complex medical approval cases, makes decisions on medical necessity and coverage, handles escalations, and ensures compliance with insurance guidelines.

About this role

We’re Hiring | Senior Medical Approvals Officer

Are you a medical professional with solid experience in Medical Approvals and a strong ability to handle complex cases?

Limitless Care is looking for a Senior Medical Approvals Officer to join our team

Requirements

• Review and make decisions on complex medical approval cases based on medical necessity, appropriateness, and coverage policies.
• Handle escalated cases and provide sound medical recommendations.
• Ensure patient care considerations are addressed while maintaining compliance with medical and insurance guidelines.
• Support the quality and consistency of the medical approvals process.
• Collaborate with internal teams and stakeholders to ensure timely case resolution.

Qualifications:
• Bachelor’s degree in Pharmacy.

• 3+ years of experience in Medical Approvals.

• Strong knowledge of medical insurance and approval processes.

• Strong analytical, decision-making, and problem-solving skills.

• Excellent communication and interpersonal skills.

• Good command of Microsoft Office.

Skills

Analytical SkillsCase ManagementComplianceDecision-makingMedical ApprovalsMedical InsuranceMicrosoft OfficePharmacy

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