Job Description

Job Category: Administration
:

• Assisting, liaising and networking between insurance companies regarding eligibility, payments, approvals, reconciliation and other requirements.
• Responsible for Assisting and supporting initiatives relative to the evaluation, processing, and handling of claims for the outpatient department.
• Acts as a liaison between the department, its insurance provider and agents, claimants, and policy holders regarding the status and eligibility for coverage for all relevant claims.
• Responsible for filing and tracking insurance claims and informing department staff of their patient's claims status
• Reviews claims to make sure that billing requirements are met, updates accounts as necessary, answers inquiries, and makes recommendations for resolution.
• Process insurance claims in a timely manner
• Maintains strict confidentiality related to medical records and other data
• Ensuring coverage of claims, guiding staff for correct usage of claim forms, approval papers
• Interact on a daily basis with doctors, and Therapists (PT OT, SLP) to insure accuracy and completion of billing
• Assisting with insurance companies for obtaining information on new policies and their coverage.

Responsibilities:

• Assisting, liaising and networking between insurance companies regarding eligibility, payments, approvals, reconciliation and other requirements.
• Responsible for Assisting and supporting initiatives relative to the evaluation, processing, and handling of claims for the outpatient department.
• Acts as a liaison between the department, its insurance provider and agents, claimants, and policy holders regarding the status and eligibility for coverage for all relevant claims.
• Responsible for filing and tracking insurance claims and informing department staff of their patient's claims status
• Reviews claims to make sure that billing requirements are met, updates accounts as necessary, answers inquiries, and makes recommendations for resolution.
• Process insurance claims in a timely manner
• Maintains strict confidentiality related to medical records and other data
• Ensuring coverage of claims, guiding staff for correct usage of claim forms, approval papers
• Interact on a daily basis with doctors, and Therapists (PT OT, SLP) to insure accuracy and completion of billing
• Assisting with insurance companies for obtaining information on new policies and their coverage.

Qualifications: 8. QUALIFICATION, EDUCATION AND EXPERIENCE
ESSENTIAL PREFERRED
Education

• Recognised degree or diploma in Insurance and Claims

• B.Sc Degree or Masters Degree

Experience

• Meticulous attention to detail with the ability to multi-task
• Excellent English language skills, Arabic would be an advantage
• Experience working with diverse populations in multicultural settings
• Excellent interpersonal and communication skills
• Excellent documentation, communication and IT skills
• Passionate about healthcare excellence

• 2-3 years Insurance or claims experience in a clinic or hospital setting
• Knowledge of ICD and CPT billing codes

Job Specific Knowledge and Skills

• Working knowledge of medical terminology
• Familiar with standard concepts, practices, and procedures in Medical Insurance

• Strong organisational, administrative and planning skills