Job Description

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.

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.