Job Description

Purpose and Scope of the Job
Preparation & re-submission of suspended/rejected claims with required documents, communicate with insurance companies for the re-submission and payment settlement claim resubmission.
Main Duties and Responsibilities/Performance Standards
1
Re-submission of claims, follow up of payments in re-submission.
2
Prepares all documents required for the re- submission.
3
Provides information of queries related to claims.
4
Submits reports on the re- submission status, rejections and improvements.
5
Prepares & Maintains the analytical reports regarding rejection (dept., reception, service, doctor wise .
6
Coordinates with accountant for the settlement of the payments and adjustments.
7
Communicates to concerned people for rejection to take further precautions.
8
Performs miscellaneous job related duties as assigned
9
Adheres to established departmental policies s and procedures.
10
Maintains departmental records and files, and takes care of departmental equipment.
11
Participates in the departmental meetings, trainings and educational programs.
12
Performs the duty as per the assigned weekly, fortnightly and monthly scheduled, shifts and timings by the supervisors or department.
13
Ensures the timely Submission of claims to internal section and to the insurance company as per assigned schedule and tar et dates.
14
Participates the planning, organizing and development for the achievement of the departmental goals.
15
Ensures safety standards (occupational and patient safety) are complied.