Job Description

Responsible for performing pre-certification; prospective, concurrent and retrospective review of hospitalization; and to ensure that cost containment measures are carried out without compromising on the care quality and service standards.

Roles and Responsibilities

• To support and lead a team of assessors in pre-certification, hospitalization, case management in the issuance of guarantee letter in compliance to Company’s requirements and guidelines.
• To ensure quality audits are done for the respective team members.
• To pre-certify cases for issuance of guarantee letter in compliance to Company’s requirements and guidelines assist the team target productivity benchmark.
• To ensure guarantee letters are issued accurately and correctly within targeted TAT and with authority assigned.
• To assist in the assignment and monitoring of all documents received in their respective team’s queues.
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