Specialist - Financial Counselling (SEHA Fertility Center)

Job description

To ensure that every IVF patient receives clear, accurate and documented financial information before treatment. The officer coordinates insurance benefits, authorization status, cost estimates, patient responsibility, deposits and financial clearance.
 

•    Bachelor’s degree in healthcare administration, finance, business or a related field preferred.
•    Two to four years’ experience in UAE healthcare insurance, patient access or revenue-cycle management.
•    IVF/ART experience strongly preferred.
•    Knowledge of benefit verification, prior authorization, patient estimates and healthcare billing.
•    Ability to use EMR/HIS systems, payer portals and spreadsheets.
•    Strong spoken and written Arabic is highly desirable.
•    Female candidate 

Key responsibilities:

• Preparing the financial estimate

  - Prepare a dated written estimate based on the physician’s treatment plan, approved clinic prices, payer contract and authorization.

• Patient financial counselling

  - Explain the estimate 

  - Clearly distinguish: 

  • Covered services.
  • Patient share.
  • Non-covered services.
  • Self-pay services.
  • Explain cancellation, incomplete-cycle, refund, storage-renewal and payment-plan conditions.
  • Obtain the patient’s signed financial acknowledgement.
  • Provide a revised estimate and repeat counselling after any material treatment or cost change.
•  Authorization coordination
  • Approved service code or bundle.
  • Approved quantity.
  • Validity period.
  • Approved medication route.
  • Financial conditions and exclusions.
  • Escalate mismatches between the approved and planned service.
  • Ensure that the patient understands services outside the existing approval.
  • Reconcile the approved plan, service performed and amount explained to the patient .

•  Payment and account coordination

  Work with the authorization team to confirm: 

  - Collect deposits and permitted patient shares only within delegated authority and clinic policy.

  - Coordinate payment posting and receipts with the cashier.

  - Monitor outstanding balances, unapplied deposits and credit balances.

  - Refer payment plans, discounts, refunds and write-offs to the authorized manager.

  - Coordinate storage-renewal notifications and unresolved storage accounts.

  - Prevent duplicate collection for services .

• Documentation and compliance

  - Maintain the following in the  system:

  - Benefit-verification source and date.

  - Version-controlled cost estimate.

  - Signed financial acknowledgement.

  - Patient questions and decisions.

  - Payment or deposit record.

  - Authorization amendments.

  - Revised estimates.

  - Refund and credit-balance follow-up.

•  Reporting and improvement

  - Maintain financial-clearance and counselling worklists.

  - Report cycles due to start without complete clearance.

  - Track estimate-to-actual cost variances.

  - Identify recurring patient-billing complaints.

  - Participate in denial and revenue-leakage reviews.

  - Recommend improvements to price lists, estimate templates.