Job Description
DUTIES AND RESPONSIBILITIES:
- Review and evaluate request of Health Insurance Letters of Approval (LOA) submitted by hospitals, clinics, and policyholders.
- Approve or disapprove LOA requests based on policy coverage, eligibility, and company guidelines.
- Communicate decisions clearly and professionally to healthcare providers and policy holders.
- Handle inbound and outbound calls related to LOA requests, and policy inquiries.
- Provide guidance to policyholders on coverage, and required documentation.
- Maintain accurate records of LOA approvals/denials in the system for compliance and audit purposes.
- Ensure adherence to regulatory standards and company policies in all decisions.
REQUIREMENTS:
- Graduate of any Bachelor's degree in Health Sciences (e.g., Nursing, Medical Technology, Public Health, or related field).
- Strong u...