Title Officer, Insurance Services

at  National Reference Laboratory

ID
2024-2532
Category
Revenue Cycle Management
Asset : Name
Danat Al Emarat
Location : Name
Abu Dhabi

• Ensure high accuracy in claims processes for insurance and corporate review, adhering to contractual agreements for efficient reimbursement.
• Provide customer service support for insurance verification, eligibility, and preauthorization.
• Accurately liaise with staff to ensure timely entry of insurance information and benefits.
• Verify claims compliance with billing guidelines.
• Communicate insurance guidelines and procedures to front-line staff.
• Support other departments and payers in tracking payments.
• Maintain proper records and files for claims correspondence with insurance and private or corporate businesses.
• Contribute to developing insurance guidelines, frameworks, and processes within MH.
• Analyze claim adjustments, bad debt provisions, and contractual allowances.
• Perform accuracy checks for all claim submissions and resubmissions as per agreed contracts.
• Coordinate discussions between billing clerks and utilization nurses for insurance claims process.
• Manage a collection desk for outstanding balances in the revenue cycle process.
• Develop claim reports for analysis and performance measurement.
• Develops and maintains relationships with insurance carriers to stay up to date with all billing and processing requirements.
• Responds to insurance related queries/complaints from both internal and external customers.
• Pro-actively participates in collaboration with the Line Manager to meet the division’s strategic and operational goals.
• Adheres to the division’s policies, procedures and standards while ensuring compliance with applicable regulatory bodies.
• Provides recommendations towards improving the division’s policies and procedures wherever applicable.
• Contributes towards an innovative culture of continuous improvement for enhancing operational efficiency and effectiveness.
• Participates in meetings and maintain professionalism and confidentiality as per the organization’s standard code of conduct.
• Maintains patient privacy, confidentiality, security and standards of ethics in all phases of release of the patient’s medical information.
• Timely completion of personal performance evaluation cycle