Job Description
Coordinates with stakeholders to ensure that all formalities as agreed with insurance companies are followed to minimize objections and delays in clarifications. Stakeholders include Patient Relations, Nursing, Physicians, Finance.
Monitors and follows up on prior authorization for outpatient and inpatient services where required. Conducts claims analysis before submission to insurance companies, and reconciles paid and outstanding claims, coordinating with Finance.
Demonstrates functional and business knowledge required for the job and applies it in following the requirements of insurance companies in the hospital. Anticipates and sets priorities to support department needs, following policies and procedures.
Identifies and analyzes problems, takes action to resolve them, applies sound judgment, and takes responsibility for resolution. Supports the hospital and department policies and procedures.
Qualifications
- Bachelor’s Degree in any f...