Resubmission Officer

Full job description

The Resubmission Officer will be responsible for filing and tracking insurance claims, process insurance and disability claims in a timely manner.

Process the Resubmission of rejected claims on the system, follow up with respective doctors for justification if necessary and prepare them for resubmission.

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

Ensure that all concerned teams such as FO, coders, doctors are updated on time with the rejections and corrective action is taken to avoid such instances in future.

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.

Comply with all OSH and infection control policies, standards and procedures and cooperate with hospital management to comply with those requirements.

Work accordance with the documented OSH procedures and instructions, specific responsibilities

Be familiar with emergency and evacuation procedures.

Notifying OSH Hazards, incidents, Near misses and issues and assistance with the preparation of risk assessments, incident reports.

Comply with Waste management procedures and policies

Attend applicable OSH/Infection control training programs, mock drills, and awareness programs.

Use of appropriate personal protective equipment and safety systems.

Ensure that employees follow applicable OSH/ Infection control policies, procedures, and standards.

Provide OSH information, training, and Supervision to the staff.

Report any OSH relevant Incident, Near misses and hazards in the departments in timely manner.

Make sure that incident corrective action has been implemented.

Assist with preparation of risk assessments and monitoring the control measures.

Ensure training is conducted, including general/ departmental/ FMS/ OSH orientation for new employees, and transferred employees, refresher training for department staff etc

Medical/ paramedical (Nursing, pharmacy, etc.) graduate from a recognized university.

Experience in Insurance Claims management/adjudication (minimum 2 years)

Experience in Medical Coding is preferable.

Excellent command of oral and written English.

 

Industries:Health, Wellness & Fitness

Function: Others