موظف اعتماد مطالبات

Administrative activities:

Administrative activities:

1. Review and Audit Medical Claims to ensure their accuracy.

   1. Resubmission of rejected claims

   2. Ensure that the agreed price list and provider manual from insurance companies are followed for billing the service to the respective payers.

   3. Ensure that the Billing officers are updated on time with the rejections and corrective action is taken to avoid such instances in future

   4. Handling the Resubmission of rejected claims, follow up with respective doctors for justifying the claims if necessary and prepare them for resubmission.

   5. Submit the claims with proper codes and format to insurance companies within the stipulated time.

Responsibilities

Administrative activities:

1. Review and Audit Medical Claims to ensure their accuracy.

   1. Resubmission of rejected claims

   2. Ensure that the agreed price list and provider manual from insurance companies are followed for billing the service to the respective payers.

   3. Ensure that the Billing officers are updated on time with the rejections and corrective action is taken to avoid such instances in future

   4. Handling the Resubmission of rejected claims, follow up with respective doctors for justifying the claims if necessary and prepare them for resubmission.

   5. Submit the claims with proper codes and format to insurance companies within the stipulated time.

Qualifications

1. Medical/paramedical (Nursing, pharmacy, etc..) graduate from a recognized university

2. Experience in Insurance Claims management/adjudication (minimum 2 years)

3. Experience in Medical Coding is preferable.

4. Flexible and able to work under pressure

5. Knowledge in using computer and related software applications and proficient in using MS office programs.