Job Description

Full job Description-Insurance coordinator for submission & Resubmission.

• Submission of claims - XML file for all insurance companies in a timely fashion in line with claims adjudication rules of DHA.
• Verify the ICD10 CM codes and relevant CPT/HCPCS codes on the claim forms for submission to various insurance companies on day-to-day basis.
• Responsible for the accurate flow of medical information and patient data between physicians, patients and third-party payers with the use of accurate numeric code to define diagnostics, treatments and procedures and to enter this information into the facility's database using medical coding protocol to produce a statement or claim.
• Coordinating with Insurance Doctors and Billing Supervisor/Accountants for E-claim & Riyati Submission & Resubmissions.
• Ensure timely resubmissions of all eligible OP claims with proper medical justification. Communicating with the payers for any clarification regarding the rejected claims at 1st resubmission and 2nd resubmission-reconciliation stage.
• Interacting with the Insurance head & Physicians for the clinical justification on the rejected claims.
• Ensure and work closely with the Insurance head on complex cases that need experience and specialist knowledge or technical IT support.
• Working closely with Insurance Team to minimize the claims denials
• Making sure that claim resubmissions are dealt with according to Insurance industry and DHA regulations.
• Ensures that targets are met with in turnaround time and while maintain quality and productivity.
• Maintain accurate monthly data of claims resubmissions /reconciliations of each insurance company
• Maintain a detailed statement of insurance denials segregated to technical denials and medical denials and provide a report to the Insurance head to facilitate the proper denial management plan and required training and documentation enhancement.
• If required would be able to take the insurance approvals and co-ordinate with the insurance team & Reception for any challenges.

Skills Required:

• Strong medical background to handle Submission, Resubmission & Reconciliation efficiently.
• Good decision-making skills.

Job Type-Full time, Timings-1pm to 10pm

Can Join immediately

Job Types: Full-time, Permanent

Pay: AED2,500.00 - AED3,000.00 per month