Submission & Resubmission Officer
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Key skills for this role
About the Role
Review and audit medical claims, resubmit rejected claims, ensure compliance with billing procedures, and possess medical qualifications with insurance claims experience.
Key Skills for This Role
Responsibilities
- Review and audit medical claims to ensure accuracy
- Resubmit rejected claims
- Ensure agreed price list and provider manual from insurance companies are followed for billing
- Update billing officers on rejections and corrective actions
- Follow up with doctors for justifying claims if necessary and prepare for resubmission
- Submit claims with proper codes and format to insurance companies within stipulated time
- Perform any other jobs or duties assigned by HOD within scope of job title
Requirements
- Experience in medical claims review and audit
- Knowledge of insurance company price lists and provider manuals
- Ability to handle resubmission of rejected claims
Full Job Posting
Key Responsibilities
- Review and Audit Medical Claims to ensure their accuracy
- Resubmission of rejected claims
- Ensure that the agreed price list and provider manual from insurance companies are followed for billing
- Ensure that the Billing officers are updated on time with the rejections and corrective action is taken
- Handling the Resubmission of rejected claims, follow up with respective doctors for justifying the claims if necessary
- Submit the claims with proper codes and format to insurance companies within the stipulated time
- Performs any other jobs or duties assigned by the HOD from time to time within the scope of job title
OSH Roles & Responsibilities
- Comply with reasonable OSH instructions, policies and safe working procedures
- Use of appropriate personal protective equipment and safety systems
- Be familiar with emergency and evacuation procedures
- Not willfully or recklessly endanger anyone’s health and safety
- Assist with the preparation of risk assessments
- Report OSH Hazards, incidents, Near misses and issues
- Reduce, Reuse, Recycling of waste as much as possible
- Attend all OSH Trainings, awareness programs and mock drills
- Participates in the OSHMS audits, inspections, ensuring standards are maintained
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