Job Description & How to Apply Below
Overview
Manages insurance approvals for insured patients. Liaises between NMCRHSHJ and Insurance Companies.
Responsibilities- Coordinates with clinicians and/or other clinical staff of different specialities for gathering relevant information/documentation for onward submission.
- Liaises with Insurance Companies/TPAs for submitting, resubmitting and replying queries raised by Insurance Companies/TPAs efficiently.
- Shows knowledge of medical terminologies and good command on pronouncing medical words.
- Demonstrates strong attention to details and ability to multitask within the fast- paced, high-pressure work environment.
- Able to manage filing and tracking approval/denials/queries and inform concerned clinicians and patients about the requested service(s) status.
- Prepares cost estimation accurately as per the current agreed terms.
- Responsible for maintaining an active database of the instructions/communication about Insurance Companies/TPAs from RCM Office.
- Practices professional telephone etiquette and customer service while making claim inquires and quickly resolving any patient complaints and concerns.
- Provides aid to Front Desk Staff regarding Insurance Protocols and Coverage.
- Maintains strict confidentiality related to medical records and other data.
- Bachelor’s degree from an accredited college / university. Coding and claims processing skills will be preferred.
- Certification from AAPC / AHIMA is a must.
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