Job Description
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.
Responsibilities
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.
Qualifications
QUALIFICATION, LICENSURE, EDUCATION, EXPERIENCE, SPECIAL SKILLS :
- 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.
