Job Description

3.1 Review and AuditMedical Claims to ensure their accuracy.

3.2 Resubmission of rejected claims.

3.4 Ensure that the agreed price list and provider manual from insurance companies are followed for billing the service to the respective payers.

3.5 Ensure that the Billing officers are updated on time with the rejections and corrective action is taken to avoid such instances in future.

3.6 Handling the Resubmission of rejected claims, follow up with respective doctors for justifying the claims if necessary and prepare them for resubmission.

3.7 Submit the claims with proper codes and format to insurance companies within the stipulated time.

Review and audit medical claims to ensure accuracy and compliance

• Resubmit rejected claims after necessary corrections and validation
• Ensure billing is done in accordance with agreed price lists and insurance provider manuals
• Keep billing officers informed of claim rejections and ensure corrective actions are implemented to prevent recurrence
• Coordinate with treating physicians to obtain justification for rejected claims and prepare them for resubmission
• Submit claims with accurate coding and correct format to insurance companies within stipulated timelines

• Medical or Nursing graduate from a recognized university
• Experience in insurance claims resubmission
• Medical coding experience preferred
• Excellent command of spoken and written English