lamiyanafsa

Provide all kinds of insurance assistance to center department and doctor. • Send authorization request to insurance companies. • Receive approvals from insurance companies and resend denials queries. • Receive remittance advice and upload to center software. • Analyzes the rejections from the XML remittance advice. • Sort out the rejection as per denial reason. • Sends the rejected claims for the respected doctors for justifying the claims if necessary and follow up with the doctors within the specified time. • Coding and resubmission in Insta.

• Submitting & Resubmitting claims of different medical centers (EMC, TMC, DMMC, EJMC, Health go, Dr. Nasser, SMC, Duo prime, Hope, Ansari, Medline) • Handling claims of different insurances - Oman, Daman - basic, network 5,Thiqa , Inayah, mednet, Fmc, Next care, Aafiya, Nas, Adnic, Neuron. • Claim re-submission and Sending the requests to doctors for the confirmation of diagnosis/services • Checking bill payments and copay as per the agreed discount • Notify bulk rejections and discussing it with corresponding insurance • Coordinate meeting for the coders for denial management & doubt clarification & updating on weekly basis • Checking approvals and eligibility • Supporting documents are collected and attached with the claim for resubmission