Insurance Billing Officer
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New
Job summary
Vet patient eligibility, obtain pre-authorizations, bill and track claims, verify claim form accuracy, prepare and record claims, maintain workstations, attend meetings, and perform assigned duties.
Min Qualification:
Diploma
Experience Level:
Entry level
Experience Length:
2 years
Job descriptions & requirements
DUTY STATION : Lifelink Hospital, Lifelink Medical Centre
DEPARTMENT: Insurance
POSITION : Insurance Billing Officer
REPORTS TO : Head of Insurance Desk
JOB REQUIREMENTS
- Minimum of Diploma in Clinical Medicine, Nursing from a recognized institution, OR Bachelor’s Degree in Business Administration or related courses from a recognized institution
- Experience: Minimum of 2 years’ experience as an Insurance Officer or in a similar role
CORE COMPETENCIES
- Written and oral communication
- Proficiency in MS Office
- Interpersonal skills
- Customer care skills
- Observant and detail-oriented
- Ability to work under pressure
KEY PERFORMANCE INDICATORS
- Accurate billing in HMIS Systems, SMART & claim forms
- Ability to meet timelines and deadlines
- Claims tracking & accountability
- Process compliance
- Pre-authorization
- Relationship management
SPECIFIC JOB RESPONSIBILITIES
VETTING
- Ensure patients are covered for services being offered through checking fingerprints, card validity, and card ownership.
- Ensures patients are treated within their limits of cover
- Ensures that we do not treat expired/ineligible members.
- Notifies relevant staff to attend to clients.
PRE-AUTH SEEKING
- Ensure to seek authorization for procedures, admission, ambulance pickups/drops before the service is provided or given to the patient.
- Ensures documented authorizations from all insurance partners through emails or handwritten letters.
- Responsible for attaching approvals on claims before submission to the claim’s office in Accounts.
BILLING/SMARTING/TRACKING
- All claims are to be billed using the different billing systems, i.e., Tracksol, Smart, AAR, Sancare, etc.
- For all claims billed off the 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 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.
- To always make sure that the insurance work stations are kept clean and tidy.
- Always account for equipment received from the head of department.
- Attend all insurance team meetings as may be communicated by the head/supervisors.
- Any other duties as may be assigned by the supervisors.
How to Apply:
All applications will be received and reviewed through the BrighterMonday Portal by clicking on the 'Apply Here' section
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