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, and doctors are updated on time with the rejections, and ensure corrective action is taken to avoid such instances in the future.
• Submit the claims with proper codes and format to insurance companies within the stipulated time.
• Perform any other jobs or duties assigned by the HOD from time to time within the scope of the job title.
• Comply with all OSH and infection control policies, standards, and procedures, and cooperate with hospital management to comply with those requirements.
• Work in accordance with the documented OSH procedures and instructions, specific responsibilities.
• Be familiar with emergency and evacuation procedures.
• Notify OSH hazards, incidents, near misses, and issues, and assist with the preparation of risk assessments and incident reports.
• Comply with waste management procedures and policies.
• Attend applicable OSH/Infection control training programs, mock drills, and awareness programs.
• Use 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 incidents, near misses, and hazards in the departments in a timely manner.
• Make sure that incident corrective actions have 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, as well as refresher training for department staff.

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.