موظف عمليات فوترة التأمين

Company

Thumbay Labs

About the role

Effective billings of External Clients Cash, Home collections, Covid & Insurance Laboratory samples. Checking Eligibility of insurance patients, calculating co-pays and sending claims for approvals. Receiving samples from messengers, marking correctly and passing to accessioning after Billing. Co-coordinating with clients through mails & calls regarding their queries & Approval status, Updating the tracker & Preserve the unbilled samples properly.

Responsibilities

Primary Responsibility
• Perform Cash, Insurance, Covid & Home collection billings effectively.
• Handling all types of laboratory samples.
• Collect data from the patient records, analyze, assign appropriate code and enter into the LIMS.
• Translate medical terminology into a standardized format, allowing information to be transmitted accurately and efficiently between healthcare providers and insurance payers.
• Ensure knowledge on anatomy, medical terminology, health conditions, and medications to assign diagnostic and procedural codes for each patient encounter.
• Responsible for correctly coding healthcare claims in order to obtain reimbursement from insurance companies and government healthcare programs`
• Utilize specialized medical classification software to assign procedure and diagnosis codes for insurance billing
• Review claims data to ensure that assigned codes meet required legal and insurance rules and that required signatures and authorizations are in place prior to submission.
• If a claim is denied due to incorrect coding, the coding specialist conducts medical records research and corresponds with insurance companies and healthcare professionals to resolve the issue.
• Receive the Insurance Claims, analyze and assign appropriate code and enter into the e-claim.
• Ensure all the patient records are complete before assigning the appropriate codes
• In case the records are not complete, intimate the deficiency and get it completed.
• Analyze the diagnostic data and prepare reports for Statistical purpose.
• Ensure 99% accuracy in Medical Coding.
• Provide technical guidance to physicians and other departmental staff in identifying and resolving issues or errors such as incomplete or missing records and documentation, ambiguous or nonspecific documentation, or codes that do not confirm to approved coding principles/guidelines
• Retrieve patient records for doctors and nurses who need to know prior history for future diagnosis and treatment.
• Keep track of medical records to document improvement or deterioration in condition.
• Processes the admission and discharge paperwork based on the instructions from the concerned.
• Ensure to protect patient privacy by keeping medical histories confidential.
• Review records to determine if the records contain the personal information and treatment details the law requires and ensure its completeness.
• Organize and keep numbers for clinical databases and patient registries to help hospitals and clinics track a treatment’s long-term effectiveness.
4.2 Secondary Responsibility
• Maintain professional conduct with internal and external customers for a robust working environment.
• Ensures adequate focus on personal professional growth relevant to taking on more challenging assignments.
• Attends training for self-development.
• Participates in the performance evaluation system.
• Perform other duties as and when assigned based on the requirement.

What we're looking for

• Attention to Detail • Multitasking • Interpersonal Skills • Effective Communication Skills • Telephone Etiquettes • Team Building Skills • Emotional Intelligence • Ability to work under pressure

Skills required

• Billing
• Compliance With Billing Guidelines
• Communication
• Time Management

Qualification

Any

Experience

2-4

Languages

• English