Insurance Claims Management

• Prepare, review, and submit insurance claims to companies.
• Follow up on unpaid or denied claims.
• Ensure timely and accurate reimbursement from insurers.

Verification and Authorization

• Verify patients’ insurance eligibility and coverage.
• Obtain pre-authorizations or approvals for specific services or procedures.

Liaison with Insurance Providers

• Communicate with insurance companies to resolve discrepancies or claim issues.
• Maintain good relationships with provider representatives.

Patient/Client Communication

• Explain insurance benefits and coverage to patients or clients.
• Inform them about their financial responsibilities (e.g., co-pays, deductibles).

Record Keeping and Data Entry

• Maintain accurate records of all insurance transactions and communications.
• Input patient or policyholder data into management systems.

Compliance and Regulation Monitoring

• Ensure adherence to insurance guidelines and legal regulations.
• Stay updated on changes in insurance policies and procedures.

Billing Coordination

• Work closely with billing departments to reconcile insurance payments.
• Address billing discrepancies.

Reporting and Analysis

• Prepare reports related to insurance claims, denials, and reimbursements.
• Analyze trends and propose process improvements.

Skills and Qualifications Typically Required:

• Knowledge of insurance policies, medical coding (e.g., ICD-10, CPT), and billing procedures.
• Familiarity with healthcare management systems (e.g., EPIC, Cerner).
• Strong attention to detail and organizational skills.
• Good communication and problem-solving abilities.
• Experience in a healthcare or administrative setting is often preferred.

•  UNIT HEAD - Financial Advisor
• 7 to 10 years of team management experience of a sales team