Job Description

• Maintain daily reconciliation processes and all action needed at hospital and client level.
• Reconciliation meetings with clients to discuss and finalize account rejections.
• Adhering to resubmission documentation during usual reconciliation process.
• Preparing resubmission reports to ensure accurate rejection recovery.
• Preparing for regularly reconciliation committee meetings to enhance the hospital reconciliation progress.
• Implementing cross audit with claim audit team to ensure accurate rejection analysis.
• Works to prepare processes and dashboards to ensure quality and accuracy.
• Undergoing action plans to mitigate rejection reasons.
• Contract and discount setup review.
• Reconciliation weekly reports.
• Stays up to date on medical updates and implements changes regarding claims and billing requirements according to customer needs to enhance digitalization internally and on customer side.
• Perform other duties related to RCM as assigned.

Qualifications:

• Bachelor’s degree of any medical field (Medicine or Dentistry).
• 3 years of working experience in claims operations/healthcare.
• Significant knowledge of claims management, reconciliation and rejections management and its financial implications.