Job Description
Job Summary
- The Health Insurance Officer is responsible for managing all health insurance related activities within the hospital, including claim verification, processing, and payment reconciliation.
- They act as a key liaison between the hospital, insurance providers, and patients, ensuring accurate and timely billing and payment for services rendered.
Key Responsibilities
- Oversee the entire billing process for health insurance claims, ensuring accurate and timely submission to insurance providers (HMOs).
- Ensure proper documentation for insurance claims, including medical coding, billing codes, and patient information.
- Resolve any discrepancies or issues with rejected claims, working closely with insurance companies and healthcare
Compliance & Documentation:
- Maintain accurate records of all billing transactions, claims, and payments.
- Stay updated on changes in healthcare insurance Policies.
Customer Service & Dispute Resolution:
- Handle inquiries from insurance companies, patients, and other stakeholders regarding billing issues, claims status, and payments.
- Work closely with the patient services department to resolve any billing-related concerns, ensuring a positive patient experience.
- Resolve billing disputes and follow up on unpaid claims to ensure timely and accurate payments.
- Prepare and process medical expressions and related documents.
- Maintain accurate insurance records and ensure timely follow-ups.
- Collaborate with departments and liaise with insurance companies effectively.
Requirements
- Minimum of 2 years of relevant experience.
- Proficiency in MS Office Suite (Word, Excel, PowerPoint).
- Excellent communication, attention to detail, and organizational skills.