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Patient Admin Executive at NMC Medical Centre

Dubai, Dubai, United Arab Emirates -

Full Time

Start Date

Immediate

Expiry Date

06 Aug, 26

Salary

0.0

Posted On

08 May, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Insurance Billing, Medical Coding, Claims Processing, MS Office, Excel, Word, PowerPoint, TPA Management, Data Validation, Organization Skills, Interpersonal Communication, Report Generation

Industry

Hospitals and Health Care

Description

1. DUTIES AND RESPONSIBILITIES 1. Verify the items in the open bills according to TPA/payer, member ID, validity of the card, coverage, approvals/LPO, insurance plan, rate plan etc. Ensure that the bills are finalized in compliance with the contractual terms and price agreement. 1. Finalize all codified credit bills for batch/statement generation based on the submission cycle (e.g., weekly, monthly etc). In the case of pharmacy claims, check the transactions according to TPA/payer, member ID, validity of the card, coverage, approvals/LPO, insurance plan, refunded transactions etc and confirm the bill. 2. In the case of insurance claims, prepare the xml batch for the finalized claims and validate in the regulator’s portal. Correct errors if any. In the case of corporate and individual payers prepare statement of claims for the period. 3. In the case of pharmacy claims, check the transactions according to TPA/payer, member ID, validity of the card, coverage, approvals/LPO, insurance plan, refunded transactions etc. 4. Ensure that the claims are appropriately dispatched by receiving the acknowledgement slip or verifying the regulatory post office with facility license number. 5. Can prepare required monthly reports upon request. 6. Performs any other jobs or duties assigned by the HOD from time to time within the scope of job title.

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Responsibilities

Responsible for verifying, finalizing, and submitting insurance and pharmacy claims to payers in compliance with contractual terms. This includes preparing XML batches for regulatory portals and generating monthly reports.