The Insurance Coordinator is responsible for managing and coordinating all insurance-related activities within the hospital. This includes verifying patient insurance coverage, processing claims, and ensuring effective communication between patients, healthcare providers, and insurance companies. The Insurance Coordinator plays a vital role in facilitating the claims process and ensuring a smooth experience for patients regarding their insurance benefits.
Key Responsibilities
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Insurance Verification
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Verify patient insurance coverage and benefits prior to admission or treatment.
Ensure that all necessary pre-authorizations are obtained for procedures and services as required by insurance companies.
Claims Processing
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Assist in preparing and submitting insurance claims for inpatient and outpatient services, ensuring accuracy and compliance with insurance requirements.
Monitor the status of claims and follow up on outstanding claims with insurance providers.
Patient Assistance
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Act as the primary point of contact for patients regarding insurance inquiries, benefits, and claims status.
Provide clear explanations to patients about their insurance coverage, payment responsibilities, and the claims process.
Documentation and Record Keeping
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Maintain accurate and organized records of insurance verifications, claims submissions, and correspondence with insurance companies.
Ensure all documentation is up-to-date and readily available for audits and compliance checks.
Collaboration with Healthcare Providers
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Work closely with clinical departments to ensure accurate coding and documentation for all services rendered to patients.
Collaborate with billing staff to ensure that all necessary information is captured for timely claims processing.
Dispute Resolution
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Address and resolve any discrepancies or issues related to insurance claims or patient billing inquiries.
Communicate effectively with insurance companies to clarify issues and seek resolutions for denied or delayed claims.
Reporting
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Assist in preparing reports on insurance claims, including metrics related to approval rates, denials, and outstanding claims.
Provide feedback to the Insurance Manager regarding trends or issues encountered in the claims process.
Compliance
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Ensure compliance with hospital policies, regulations, and insurance company requirements regarding claims processing.
Stay updated on changes in healthcare laws and insurance policies that may affect the hospital's operations.
Job Type: Full-time
Pay: From ?10,000.00 per month
Work Location: In person
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