Job Description

Job description

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Generate and analyze financial reports related to insurance claims, payments, and denials.

Provide regular updates and insights to management on revenue cycle performance and areas for improvement.

Ensure compliance with all relevant laws, regulations, and accreditation standards related to insurance billing and revenue cycle management.

Identify and mitigate risks associated with insurance claims and payments.

Obtaining prior approvals for the services requiring pre-authorization as per medical coding guidelines.

Coordinating with any requirements from Insurance companies and following insurance protocols

Checking all the coverage and member eligibility

Informing front desk staff for any new protocols received from insurance companies

Ensuring approvals are received with correct details

Ensure that the invoices are correctly done in line with what is approved

Working with problem claims & denials

Co-ordination OP cases regarding various CPT codes used for accurate and effective Billing

Ensuring Pre-approval process is done as per the DOH and DHA coding guidelines

To liaise with patients regarding their eligibility, entitlements, and coverage of medical benefits

Assist on submitting the claims on timely manner.

The Junior Insurance Coordinator must be clear and concise in communication to Insurance companies, doctors, and patients.


Adheres to dress code, appearance to maintain neat and clean

Always maintains and ensure patient confidentially

Reports to work on time and as scheduled

Work at maintaining a good rapport and cooperative working relationship with Insurance companies, doctors, and patients.

Knowledge / Education / Skills

:


1. Bachelor's degree in Finance, Business Administration, Healthcare Management, or a related field.


2. Must have a coding certification


2. Minimum of 10 years of experience in Insurance Coordinator, Revenue Cycle Management, Medical Billing, or a related role.


3. Strong understanding of insurance processes, claim management, and medical audits.


4. Proficiency in relevant software and systems for medical billing and revenue cycle management.


5. Excellent communication, negotiation, and interpersonal skills.


6. Strong analytical and problem-solving abilities.


Proficiency in English language, both written and spoken.


Experience:


10 years (Required)