Insurance Coordinator
Medeor 24x7 Hospital,
منذ 4 يوم
source : Wisdom Jobs

We are seeking for qualified individual for the position of Insurance Coordinator Understand comply and participate in hospital wide Quality Risk management safety infection prevention program Good knowledge of insurance laws rules and regulations to interpret explain and provide justification to patients and external customers on actions taken Obtain approvals from the concerned insurance companies for patients when required Obtaining instant verbal pre-

authorization code for services Obtaining emergency verbal approval for admissions which are followed by faxed request within 24 hrs Review the In-

patient list and OT list to ensure proper approval status on a daily basis Procuring and sending all the required documents Cost estimates pre-

approval request form medical report investigation results etc while requesting for pre-authorization from insurance companies through fax email or uploading in the online system Review and distribute the pre-

approvals to concerned departments on regular basis and without delay To maintain update a pre-approval log with requests details the date and time at which they were received from each department communicated to Insurance companies approvals denials queries received and distributed to the concerned departments To clarify the queries of Insurance companies doctors Nursing staffs other hospital staffs regarding direct billing Clarifying quarries of the hospital staffs related to insurance regarding acceptability of different insurance cards at MEDEOR deductible and co-

payment services requiring pre approval excluded services Informing the nursing staffs regarding the above mentioned details status of approval of pre-

approval requests patient s benefits and available limits To Update caution Insurance companies in advance about the expense expected for long staying patients who are at risk of exhausting the available limit so that they might coordinate with the Client in advance to extend the annual limit for the said member in an attempt to avoid inconvenience to the admitted patients Ensure appropriate review of bills and statements as per the Medical Necessity requirements before sending out to insurance companies to reduce risks of denial Performs concurrent review of records claims forms to verify proper documentation of principle diagnosis and secondary diagnoses including conditions qualifying as complications co-

morbidities and major complications and co-morbidities based on the coding guidelines Participate in organizational quality improvements and patient safety programs Attend planned in house quality improvements patient safety trainings Understand and fully comply with Regulatory and accreditation bodies requirements Report any Occurrence Variance in during duty timings Any other duties assigned by the Incharge HOD Profile Summary : KeySkills : Profile Summary : KeySkills : Company Profile : Medeor 24x7 Hospital

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