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Experience
1 - 5 Years
Job Location
Education
Bachelor of Business Administration(Management)
Nationality
Any Nationality
Gender
Any
Vacancy
1 Vacancy
Job Description
Roles & Responsibilities
Verify the items in the open bills according to TPA/payer, member ID, validity of the card, coverage, approvals/LPO, insurance plan, rate plan etc. Ensure that the bills are finalized in compliance with the contractual terms and price agreement.
Finalize all codified credit bills for batch/statement generation based on the submission cycle (e.g., weekly, monthly etc). In the case of pharmacy claims, check the transactions according to TPA/payer, member ID, validity of the card, coverage, approvals/LPO, insurance plan, refunded transactions etc and confirm the bill.
In the case of insurance claims, prepare the xml batch for the finalized claims and validate in the regulator’s portal. Correct errors if any. In the case of corporate and individual payers prepare statement of claims for the period.
In the case of pharmacy claims, check the transactions according to TPA/payer, member ID, validity of the card, coverage, approvals/LPO, insurance plan, refunded transactions etc.
Ensure that the claims are appropriately dispatched by receiving the acknowledgement slip or verifying the regulatory post office with facility license number.
Can prepare required monthly reports upon request.
Performs any other jobs or duties assigned by the HOD from time to time within the scope of job title
Desired Candidate Profile
Bachelor of Commerce, Business Administration or any other degree. Paramedical or coding knowledge will be advantage.
Two years minimum of experience.
Knowledge of insurance billing procedure.
Knowledge in using computer and related software applications.
MS Office Experience, Word, Excel and Power point.
Extreme organization skills.
Communication, interpersonal skills as applied to interaction with co-workers, supervisor and customers.
Employment Type
- Full Time
Company Industry
Department / Functional Area
Keywords
- Patient Admin Executive
- Patient Experience Specialist
- Clinical Administrative Assistant
- Medical Receptionist
- Medical Billing
- Healthcare Admin Specialist
- Healthcare Administration
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NMC healthcare LLC
NMC is a diversified business conglomerate. One of the focus areas being Healthcare, with Specialty Hospitals, Medical centres and Clinics across the UAE.
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