Obtains and processes the information needed from insured or designated persons to fulfill medical insurance claims and resolve billing issues. Determines insurance coverage; examines and resolves medical claims; adheres to hospital policy of delivering quality customer service, documents actions and ensures legal and hospital compliance throughout the entire claims process.
Job Responsibilities:
• Verifies the received insurance claims & related documents from reception or billing clerk.
• Verifies all information mentioned in the claim (services/treatments with the given diagnosis, coverage and exclusions)
• Communicates with all doctors regarding missing required information or filling mistakes or rejection details and the cause.
• Verifies the rejection and prepare the required preventive action plans.
• Updates doctors about the Insurance Exclusions & Policies on a regular basis.
• Prepares report of the medical errors of the claims or other reports/statements as and when needed.
• Checks documents and registration status and maintains departmental records and files.
• Documents medical claims actions by completing forms, reports, logs, and records.
• Reviews and completes insurance-claim forms and related documents daily
• Answers any inquiries regarding insurance claims, missing documents, error corrections status.
• Protects operations by keeping claims information confidential.
• Adheres to all hospital policies, procedures and guidelines in addition to insurance regulations.
Job Details
| Posted Date: | 2021-01-10 |
| Job Location: | Al Kuwait, Kuwait |
| Job Role: | Medical, Healthcare, and Nursing |
| Company Industry: | Insurance & TPA |
Preferred Candidate
| Career Level: | Mid Career |
| Degree: | Bachelor's degree |
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