Job Description

Job Category: Administration
:
3.1 Review and Audit Medical Claims to ensure their accuracy.
3.2 Resubmission of rejected claims.
3.4 Ensure that the agreed price list and provider manual from insurance companies are followed for billing the service to the respective payers.
3.5 Ensure that the Billing officers are updated on time with the rejections and corrective action is taken to avoid such instances in future.
3.6 Handling the Resubmission of rejected claims, follow up with respective doctors for justifying the claims if necessary and prepare them for resubmission.
3.7 Submit the claims with proper codes and format to insurance companies within the stipulated time.
Responsibilities:
Review and audit medical claims to ensure accuracy.
Resubmit rejected claims in a timely manner.
Ensure that billing aligns with the agreed price list and provider manual from insurance companies.
Keep billing officers informed about claim rejections and ensure corrective actions are implemented to prevent recurrence.
Handle resubmission of rejected claims, including coordinating with doctors for justification if necessary, and prepare claims for resubmission.
Submit claims with proper codes and format to insurance companies within the stipulated timeframe.
Qualifications:
Medical/Nursing graduate from a recognized university
Experience in Insurance Claims Resubmission
Experience in Medical Coding is preferable
Excellent command of oral and written English

Skills Required