EveMedical Center LLC looking to hire a presentable and experiencedInsurance Coordinator for a full-time role who is fluent in Englishand has prior experience working in a clinic.
In this role, youwill be mainly be responsible in managing and reimbursing insuranceclaims for all incoming patients and will report directly to theChief Medical Officer of the company.
Candidate should be MaleOther responsibilities will include, but not limited to :
Review, interpret, abstract clinicalinformation from medical records for the purposes of reimbursement,research and compliance utilizing established coding principles andprotocols.
Expert inmedical record review to abstract information required to supportaccurate outpatient and coding.
Expert in assigning accurate service codes for diagnosisand procedures performed in clinical setting.
Responsible for claims submission,rejection, re-submission and all sorts of insurancedocumentations.
Adhereto DOH Claims and Adjudication rules and codingguidelines.
Obtainapproval for medical / dental procedures.
Inform patients of dental office proceduresand policy.
Movepatients through appointments as scheduled.
Enter all relevant patient information intodata system.
Maintainand manage patient records in compliance with privacy and securityregulations.
Answer andmanage insurance related incoming calls.
Complete and file insurance forms and dentalbilling records.
Translate Clinical services into proper billablecodes.
Handle testresults including x-rays and dispatch lab workappropriately.
Organizereferrals to other medical specialists.
Communicate with insurance companies regardingeligibility, payments, approvals, reconciliation and otherrequirements.
Explainthe coverage of medical benefits to patients whenrequired.
Act as aresource for billing, pre-authorization, reimbursement issues andoutpatient / dental.
Ensure high level of patient dataconfidentiality.
Checkcodes for each claim to avoid any errors to minimizerejections.
Followpolicies and procedures, completes administrative tasks accuratelyand on time.
Requirements To beconsidered for the role, the following criteria should bemet :
Proven experience working in aClinic for at least 2 years.
At least 1 year of experience as an insurancecoordinator / dental coder.
Have an excellent command in English.
Knowledgeable with Clinicalterminology.
Excellentphone and in-person communication skills.
Excellent organization, time management andmultitasking abilities.
An understanding of insurance guidelines andprocedures.
Skilled inusing MS Office such as MS Word, Excel and Outlook.
Knowledgeable on THIQA, DAMAN,ADNIC, NAS, and etc. on insurance eligibility and authorizationprocess.
Should need knowledge ofempanelment
Need to done future empanelmentfor new insurance company
Pharmacy claimsProcedure as well
Ability to work 6 days a week.