Working with problem claims & denials
Getting approvals for medical procedures
Ensuring coverage of claims, guiding staff for correct use age of claim forms, approval papers
Coordinating with insurance companies for obtaining information on new policies and their coverage
Explaining coverage of medical benefits to patients when required
Assisting invoicing department in insurance processing and billing
To network with insurance companies to obtain accreditation as a provide
To liaise with insurance companies regarding eligibility, payments, approvals, reconciliation and other requirements.
To liaise with patients regarding their eligibility and entitlements.
To train and educate staff in insurance matters.
To advice the management on insurance matters.
To design and implement a protocol for insurance practices in the hospital.
To maintain and update records related to pre-approvals and reconciliation.
To coordinate and co-operate with colleagues of the same department and other related departments for smooth running of Insurance operations.