Job Description

• The Resubmission Officer will be responsible for filing and tracking insurance claims, process insurance and disability claims in a timely manner.

Responsibilities

• Process the Resubmission of rejected claims on the system, follow up with respective doctors for justification if necessary and prepare them for resubmission.
• Ensure that the agreed price list and provider manual from insurance companies are followed for billing the service to the respective payers.
• Ensure that all concerned teams such as FO, coders, doctors are updated on time with the rejections and corrective action is taken to avoid such instances in future.
• 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.
• Comply with all OSH and infection control policies, standards and procedures and cooperate with hospital management to comply with those requirements.
• Work accordance with the documented OSH procedures and instructions, specific responsibilities
• Be familiar with emergency and evacuation procedures.
• Notifying OSH Hazards, incidents, Near misses and issues and assistance with the preparation of risk assessments, incident reports.
• Comply with Waste management procedures and policies
• Attend applicable OSH/Infection control training programs, mock drills, and awareness programs.
• Use of appropriate personal protective equipment and safety systems.
• Ensure that employees follow applicable OSH/ Infection control policies, procedures, and standards.
• Provide OSH information, training, and Supervision to the staff.
• Report any OSH relevant Incident, Near misses and hazards in the departments in timely manner.
• Make sure that incident corrective action has been implemented.
• Assist with preparation of risk assessments and monitoring the control measures.
• Ensure training is conducted, including general/ departmental/ FMS/ OSH orientation for new employees, and transferred employees, refresher training for department staff etc

Qualifications

• Medical/ paramedical (Nursing, pharmacy, etc.) graduate from a recognized university.
• Experience in Insurance Claims management/adjudication (minimum 2 years)
• Experience in Medical Coding is preferable.
• Excellent command of oral and written English.