Review and Audit Medical Claims to ensure their accuracy.
Resubmission of rejected claims
Ensure that the agreed price list and provider manual from insurance companies are followed for billing the service to the respective payers.
Ensure that the Billing officers are updated on time with the rejections and corrective action is taken to avoid such instances in future
Handling the Resubmission of rejected claims, follow up with respective doctors for justifying the claims if necessary and prepare them for resubmission.
Submit the claims with proper codes and format to insurance companies within the stipulated time.
Performs any other jobs or duties assigned by the HOD from time to time within the scope of job title.
Responsibilities
Review and Audit Medical Claims to ensure their accuracy.
Resubmission of rejected claims
Ensure that the agreed price list and provider manual from insurance companies are followed for billing the service to the respective payers.
Ensure that the Billing officers are updated on time with the rejections and corrective action is taken to avoid such instances in future
Handling the Resubmission of rejected claims, follow up with respective doctors for justifying the claims if necessary and prepare them for resubmission.
Submit the claims with proper codes and format to insurance companies within the stipulated time.
Performs any other jobs or duties assigned by the HOD from time to time within the scope of job title.
Qualifications
Medical/paramedical (Nursing, pharmacy, etc…) graduate from a recognized university.
Experience in Insurance Claims management/adjudication (minimum 2 years)
