Submission & Resubmission Officer
Review and audit medical claims, resubmit rejected claims, ensure compliance with billing procedures, and possess medical qualifications with insurance claims experience.
Skills
About This Role
Overview
- 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.
General
- Comply with reasonable OSH instructions, policies and safe working procedures
- Use of appropriate personal protective equipment and safety systems.
- Be familiar with emergency and evacuation procedures
- Not willfully or recklessly endanger anyone’s health and safety
- Assist with the preparation of risk assessments
- Report OSH Hazards, incidents, Near misses and issues
- Reduce, Reuse, Recycling of waste as much as possible
- Attend all OSH Trainings, awareness programs and mock drills.
- Participates in the OSHMS audits, inspections, ensuring standards are maintained
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