Job Description

The officer acts as a

liaison between the hospital, patients,

and insurance companies to ensure accurate billing and timely reimbursement for services rendered.

The Claims Insurance Officer is a vital administrative role responsible for managing all aspects of the hospital's insurance and claims processes. This includes verifying

patient insurance coverage, submitting claims to insurance providers

, resolving claim denials and discrepancies, and ensuring compliance with all relevant regulations.

Experience

: 2 to 3 experience in Hospital Claims Insurance officer

Key Roles and Responsibilities

Claims Processing:

Review and verify patient insurance information, including eligibility, benefits, and co-pays, prior to or at the time of service. Prepare and submit medical claims to various insurance companies (government and private) in a timely and accurate manner. Ensure all claims adhere to established policies, procedures, and legal and industry regulations, including HIPAA. Maintain and update patient insurance information in the hospital's billing and records systems.

Claim Management and Resolution:

Investigate and resolve denied or rejected claims by identifying and correcting errors, providing additional documentation, and appealing decisions. Communicate with insurance companies to clarify coverage, negotiate settlements, and follow up on the status of pending claims. Address and resolve patient inquiries and concerns related to insurance coverage, billing, and claims.

Education:

A bachelor's degree in healthcare administration, business, finance, or a related field is often preferred. Relevant certifications in medical billing and coding (e.g., Certified Professional Coder - CPC) can be a significant advantage.

Experience

: 2 to 3 experience in Hospital Claims Insurance officer

Soft Skills:

Excellent written and verbal communication skills. Strong analytical and problem-solving abilities. Meticulous attention to detail and accuracy. Exceptional organisational and time-management skills to handle a high volume of work. The ability to work independently and as part of a team. Strong customer service skills to effectively communicate with patients and insurance providers, often in difficult situations. The ability to remain calm and professional under pressure.
Job Types: Full-time, Permanent

Pay: ₹10,000.00 - ₹18,000.00 per month

Work Location: In person

Speak with the employer

+91 8778376611