Job Description

Checks and compiles all Insurance claims before submitting them to the respective payers and insurance companies, using coded data to finalize and submit claims to insurance companies.

Responsibilities

• Manage account balances to discover outstanding debts or inconsistencies
• Collect all information needed to calculate bills receivable (order amounts, discount rates, etc.)
• Check data input in the accounting system to ensure accuracy of the final bill
• Issue invoices and bills, and send them to customers through various channels (mail, email, etc.)
• Issue customer account statements periodically or whenever necessary
• Receive payments through various methods (cash, online payments, etc.) and verify credibility
• Send payment reminders and contact customers when required
• Update accounting records with new payments, balances, and customer information
• Answer questions and handle customer complaints regarding bills
• Finalize bills after verifying with coders
• Submit bills
• Maintain discount form filings along with other departments
• Prepare cash cost estimates
• Submit bills on DOH as per their requirements
• For pharmacy claims, check transactions according to TPA/payer, member ID, card validity, coverage, approvals/LPO, insurance plan, refunded transactions, etc.
• Ensure claims are appropriately dispatched by obtaining acknowledgment slips or verifying with the regulatory post office using the facility license number
• Prepare required monthly reports upon request
• Perform any other duties assigned by the HOD within the job scope
• Comply with all OSH and infection control policies, standards, and procedures
• Work in accordance with documented OSH procedures and specific responsibilities
• Be familiar with emergency and evacuation procedures
• Notify OSH hazards, incidents, near misses, and support in preparing risk assessments and incident reports
• Comply with waste management procedures and policies
• Attend applicable OSH/Infection Control training programs, mock drills, and awareness programs
• Use appropriate personal protective equipment and safety systems

Qualifications

• Bachelor of Commerce, Business Administration, or any related degree; paramedical or coding knowledge is an advantage
• Minimum of two years’ experience
• Knowledge of cash billing procedures
• Proficiency in using computers and related software applications
• Experience with MS Office (Word, Excel, PowerPoint)
• Strong organizational skills
• Effective communication and interpersonal skills for interacting with co-workers, supervisors, and customers