Claims Accountant

Job Description

Key Responsibilities / Accountabilities

• Process governmental claims in a timely manner to ensure prompt and full payment.
• Review and verify governmental claims for completeness and accuracy.
• Compile claims according to government specifications, i.e. claim forms, invoices, investigation results, prescriptions, etc.
• Verify receipt of all invoices, medicine and clinical, received from Patient Services against HisGENx report on a daily basis.
• Notify and follow up with Patient Services on daily basis any invoices, medicine and clinical, that were not received from Patient Services but are listed on HisGENx report.
• Send monthly report to Patient Services Manager for any missing invoices, medicine and clinical, to ensure prompt and complete submission of company and insurance company claims.
• Review medical records to clarify information and answer questions from companies and insurance companies.
• Send letters on rejected claims and answers follow-ups on requests for information.
• Receive and tally information on incomplete claims forms from assigned General Practitioner and forward to Director of Business Services for review and signature.
• Send incomplete claims forms back to medical staff for response and follows up with medical staff to answer promptly.
• Receive and send to medical staff any rejected claims requesting clarification or other information as requested by the companies and insurance companies.
• Resubmit insurance claims that were rejected with appropriate responses to ensure prompt payment.
• Oversee work of nursing staff temporarily assigned to assist Business Services in processing claims.
• Photocopying, filing and faxing.
• Participate in person-centered care initiatives undertaken by HMG.
• Enrich patient experience with compassion, respect and dignity.
• Perform other applicable tasks and duties assigned within the realm of his/her knowledge, skills and abilities.
  

Requirements

Education/ Professional Qualification

• Bachelor’s Degree Business Administration or Commerce major in Accounting
  

Experience

• Minimum of 6 years experienced as an Accountant in Hospital Accounting
• Experience and knowledge of Medical Insurance policies required
• Minimum 5 years working experience as Claims Supervisor
  

Professional Licensing / Certification / Training

• Relevant Certification