- Review and⠀Audit⠀Medical⠀Claims to⠀ensure⠀their⠀accuracy.
- Resubmission⠀of⠀rejected⠀claims
- Ensure⠀that the⠀agreed⠀price list⠀and⠀provider⠀manual⠀from⠀insurance⠀companies⠀are⠀followed⠀for⠀billing⠀the⠀service to⠀the⠀respective⠀payers.
- Ensure⠀that the⠀Billing⠀officers⠀are⠀updated on⠀time with⠀the⠀rejections⠀and⠀corrective⠀action is⠀taken to⠀avoid such⠀instances⠀in⠀future
- Handling⠀the⠀Resubmission⠀of⠀rejected⠀claims,⠀follow up⠀with⠀respective⠀doctors⠀for⠀justifying⠀the claims⠀if⠀necessary⠀and⠀prepare⠀them for⠀resubmission.
- Submit⠀the claims⠀with⠀proper⠀codes and⠀format to⠀insurance⠀companies⠀within the⠀stipulated⠀time.
- Performs⠀any other⠀jobs or⠀duties⠀assigned⠀by the HOD⠀from time⠀to time⠀within the⠀scope of⠀job title.
DUTIES AND RESPONSIBILITIES :
- Review and⠀Audit⠀Medical⠀Claims to⠀ensure⠀their⠀accuracy.
- Resubmission⠀of⠀rejected⠀claims
- Ensure⠀that the⠀agreed⠀price list⠀and⠀provider⠀manual⠀from⠀insurance⠀companies⠀are⠀followed⠀for⠀billing⠀the⠀service to⠀the⠀respective⠀payers.
- Ensure⠀that the⠀Billing⠀officers⠀are⠀updated on⠀time with⠀the⠀rejections⠀and⠀corrective⠀action is⠀taken to⠀avoid such⠀instances⠀in⠀future
- Handling⠀the⠀Resubmission⠀of⠀rejected⠀claims,⠀follow up⠀with⠀respective⠀doctors⠀for⠀justifying⠀the claims⠀if⠀necessary⠀and⠀prepare⠀them for⠀resubmission.
- Submit⠀the claims⠀with⠀proper⠀codes and⠀format to⠀insurance⠀companies⠀within the⠀stipulated⠀time.
- Performs⠀any other⠀jobs or⠀duties⠀assigned⠀by the HOD⠀from time⠀to time⠀within the⠀scope of⠀job title.
QUALIFICATION, LICENSURE, EDUCATION, EXPERIENCE, SPECIAL SKILLS :
- Medical/paramedical⠀(Nursing,⠀pharmacy,⠀etc.)⠀graduate⠀from a⠀recognized⠀university⠀preferred.
- Experience⠀in⠀Insurance⠀Claims⠀management/adjudication⠀(minimum 2⠀years)
- Experience⠀in Medical⠀Coding is⠀preferable.
- Excellent⠀command of⠀oral and⠀written⠀English
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