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indeed

Insurance Officer / Admin

ALDAFNA MEDICAL CENTER
Baladiyat ad Dawhah, QAT
Onsite
QAR 4,094.51 to QAR 4,575.72 per month
Discovered 5 days ago
Insurance eligibility and benefits verificationPre-approvals and prior authorizationsInsurance claims processingClaims rejection investigation and resubmissionMedical documentation reviewInsurance payment reconciliation
Free

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Key skills for this role

Insurance eligibility and benefits verificationPre-approvals and prior authorizationsInsurance claims processing
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Main Duties

  • Coordinate with insurance companies and TPAs regarding patient coverage and approvals.
  • Verify patient insurance eligibility and benefits before treatment.
  • Check coverage, exclusions, co-payments, deductibles, and policy limits.
  • Obtain pre-approvals and prior authorizations for procedures, investigations, and treatments.
  • Prepare and submit insurance claims accurately and on time.
  • Follow up on pending, rejected, or unpaid claims and prepare corrections or resubmissions.
  • Coordinate with doctors, nurses, reception, and billing staff to obtain complete medical documentation.
  • Ensure medical reports, diagnosis codes, procedure codes, prescriptions, and supporting documents are complete.
  • Maintain records of approvals, claims, rejections, and payments.
  • Reconcile insurance payments with submitted claims and patient accounts.
  • Follow up with insurance companies regarding outstanding receivables.
  • Prepare reports on submitted, approved, rejected, and outstanding claims, collections, and rejection trends.

Pay

  • QAR 4,094.51 to QAR 4,575.72 per month.

Work Location

  • The work location is in person.

Requirements

  • Ability to verify insurance eligibility, benefits, exclusions, co-payments, deductibles, and policy limits accurately.
  • Ability to prepare and submit insurance claims accurately and on time.
  • Ability to coordinate with clinical, reception, billing, insurance, and TPA stakeholders to obtain complete documentation.
  • Ability to maintain accurate records and prepare reports on claims, approvals, rejections, collections, and outstanding receivables.

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