Checks and compiles all Insurance claims before submitting them to the respective payers and insurance companies, using coded data to finalize and submit claims to insurance companies.
Manage account balances to identify outstanding debts or inconsistencies.
Collect all necessary information to calculate bills receivable (order amounts, discount rates, etc.).
Verify data entered in the accounting system to ensure accuracy of final bills.
Issue invoices and bills to customers via various channels (mail, email, etc.).
Issue customer account statements periodically or as needed.
Receive payments through multiple methods (cash, online payments, etc.) and verify credibility.
Send payment reminders and contact customers when assigned.
Update accounting records with new payments, balances, and customer information.
Answer questions and handle customer complaints regarding bills.
Finalize bills after verification with coders.
Submit bills to relevant authorities and manage bill submission processes.
Maintain discount forms and related documentation in coordination with other departments.
Prepare cash cost estimates as required.
Submit bills to DOH in accordance with their requirements.
For pharmacy claims, verify transactions according to TPA/payer, member ID, card validity, coverage, approvals/LPO, insurance plan, and refunds.
Ensure claims are properly dispatched, receiving acknowledgement slips or verifying through the regulatory post office with facility license number.
Prepare required monthly reports upon request.
Perform any other duties assigned by the HOD within the scope of the job title.
Occupational Safety & Health (OSH) / Infection Control Responsibilities:
Comply with all OSH and infection control policies, standards, and procedures, cooperating with hospital management.
Work in accordance with documented OSH procedures and instructions.
Be familiar with emergency and evacuation procedures.
Notify management of OSH hazards, incidents, near misses, and assist with preparation of risk assessments and incident reports.
Comply with waste management procedures and policies.
Attend OSH/Infection control training programs, mock drills, and awareness programs.
Use appropriate personal protective equipment (PPE) and safety systems.
Education: Bachelor’s degree in Commerce, Business Administration, or any other relevant field. Paramedical or coding knowledge is an advantage.
Experience: Minimum of 2 years in a relevant role.
Technical Skills:
Knowledge of cash billing procedures.
Proficient in computer and software applications.
Experienced in MS Office – Word, Excel, and PowerPoint.
Organizational Skills: Strong organization and time management abilities.
Interpersonal Skills: Effective communication and interpersonal skills for interaction with co-workers, supervisors, and customers.
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