INSURANCE BILLING OFFICER

KEY RESPONSIBILITIES

VETTING

• Ensure patients are covered for services being offered through checking finger prints, card validity and card ownership.
• Ensures patients are treated within their limits of cover
• Ensures we do not treat expired/ineligible members.

PRE-AUTH SEEKING

• Seek authorization for procedures, admission, ambulance pickups/drops before the service is provided or given to the patient.
• Have documented authorizations from all insurance partners through emails or hand written letters.
• Attach approvals on claims before submission to the Claims office in Accounts.

CUSTOMER SERVICE/CARE

• Responsible for ensuring all insurance patients are well received, are given all the necessary information relating to their treatment, cover and are smoothly taken through the system (hospital) with minimum setbacks.
• Provide good customer care

BILLINGS/MARKING/TRACKSOLING

• All claims are to be billed using the different billing systems i.e., Track sol, Smart, AAR, Sancare etc.
• For all claims billed off system a reimbursement should be sent and the authorizing person indicated.

CHECKING CLAIM FORMS

One has to go through the claim forms and see if they were properly billed and if they were fully filled and finalized as follows:

Claims date, Employee company /employer, Employee name, Patient phone number, Diagnosis, Key symptoms, Proof of authorizations attached, Services itemized and each billed individually, Claims billed & Signature: Patient & Doctor

PREPARATION OF CLAIM FORMS

• All claim forms must be posted and excelled for proper record keeping and reconciling.

OTHERS RESPONSIBILITIES

• Ensure that the Insurance Billing work stations are kept clean and tidy.
• Always account for equipment received from the Head of Department.
• Attend all Insurance Billing team meetings as may be communicated by the head/supervisors.
• Any other duties as may be assigned by the supervisors.

KEY RESULTS AREAS

• Accurate billing in HMIS Systems, SMART & claim forms
• Ability to meet timelines and deadlines
• Claims tracking & accountability
• Process compliance
• Pre-authorization
• Relationship management

How to Apply:

All applications will be received and reviewed through the BrighterMonday Portal by clicking on the 'Apply Here' section