Description

Job Description

Job Description

• 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

• Bachelor’s degree in Finance, Business Administration, Healthcare Management, or a related field.
• Must have a coding certification
• Minimum of 10 years of experience in Insurance Coordinator, Revenue Cycle Management, Medical Billing, or a related role.
• Strong understanding of insurance processes, claim management, and medical audits.
• Proficiency in relevant software and systems for medical billing and revenue cycle management.
• Excellent communication, negotiation, and interpersonal skills.
• Strong analytical and problem-solving abilities.

Proficiency in English language, both written and spoken.

Experience

10 years (Required)