About the Role
The role involves checking and compiling insurance claims before submitting them to the respective payers and insurance companies. It requires using coded data to finalize and submit claims, ensuring accuracy and compliance throughout the billing process.
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Responsibilities
- Manage account balances to discover outstanding debts or other inconsistencies
- Collect all information needed to calculate bills receivable (order amounts, discount rates, etc.)
- Check the data input in the accounting system to ensure accuracy of the final bill
- Issue invoices and bills and send them to customers through various channels (mail, e-mail, etc.)
- Issue customer account statements periodically or whenever necessary
- Receive payments through various methods (cash, online payments, etc.) and check for credibility
- Send reminders for payments and contact customers when assigned
- Update accounting records with new payments, balances, customer information, etc.
- Answer questions and handle complaints from customers regarding bills
- Finalize bills after verifying with coders
- Submit bills
- Maintain discount forms filing along with other departments
- Prepare cash cost estimates
- Submit the bills on DOH as per their requirements
- For pharmacy claims, check the transactions according to TPA/payer, member ID, validity of the card, coverage, approvals/LPO, insurance plan, refunded transactions, etc.
- Ensure that claims are appropriately dispatched by receiving the acknowledgement slip or verifying the regulatory post office with facility license number
- Prepare required monthly reports upon request
- Perform any other jobs or duties assigned by the HOD from time to time within the scope of job title
- Comply with all Occupational Safety and Health (OSH) and infection control policies, standards, and procedures
- Familiarize with emergency and evacuation procedures
- Notify OSH hazards, incidents, near misses, and issues, and assist 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 appropriate personal protective equipment and safety systems
Qualifications
- Bachelor of Commerce, Business Administration, or any other degree. Paramedical or coding knowledge is an advantage
- Minimum of two years of experience
- Knowledge of cash billing procedure
- Proficient in using computers and related software applications
- Experienced with MS Office, including Word, Excel, and PowerPoint
- Strong organizational skills
- Excellent communication and interpersonal skills as applied to interaction with co-workers, supervisors, and customers.
