Job Description

Job Category: Administration
:
Checks and compiles all Insurance claims before submitting them to the respective payers and insurance companies, using coded data to finalize and submit claims to insurance companies.
Responsibilities:
Manage account balances to discover outstanding debts or inconsistencies
Collect all information needed to calculate bills receivable (order amounts, discount rates, etc.)
Check data input in the accounting system to ensure accuracy of the final bill
Issue invoices and bills, and send them to customers through various channels (mail, email, etc.)
Issue customer account statements periodically or whenever necessary
Receive payments through various methods (cash, online payments, etc.) and verify credibility
Send payment reminders and contact customers when required
Update accounting records with new payments, balances, and customer information
Answer questions and handle customer complaints regarding bills
Finalize bills after verifying with coders
Submit bills
Maintain discount form filings along with other departments
Prepare cash cost estimates
Submit bills on DOH as per their requirements
For pharmacy claims, check transactions according to TPA/payer, member ID, card validity, coverage, approvals/LPO, insurance plan, refunded transactions, etc.
Ensure claims are appropriately dispatched by obtaining acknowledgment slips or verifying with the regulatory post office using the facility license number
Prepare required monthly reports upon request
Perform any other duties assigned by the HOD within the job scope
Comply with all OSH and infection control policies, standards, and procedures
Work in accordance with documented OSH procedures and specific responsibilities
Be familiar with emergency and evacuation procedures
Notify OSH hazards, incidents, near misses, and support in preparing 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
Qualifications:
Bachelor of Commerce, Business Administration, or any related degree; paramedical or coding knowledge is an advantage
Minimum of two years' experience
Knowledge of cash billing procedures
Proficiency in using computers and related software applications
Experience with MS Office (Word, Excel, PowerPoint)
Strong organizational skills
Effective communication and interpersonal skills for interacting with co-workers, supervisors, and customers

Skills Required