Experience : 2+ Years
Location : QATAR (Local Candidates Preferred)
Mandatory Requirement : 2+ years’ of experience in medical billing using an electronic billing and insurance system
KEY ROLE ACCOUNTABILITIES
Releases completed claims for submission.
Requests additional information from clinical areas in response to claims denials or inquiries by insurance
Prepares and processes claims based on claims work lists for submission to insurance providers or TPAs.
Verifies claims for accuracy and completeness of information.
Communicates with clinical areas to resolve any claim edits issues.
Ensures that claim formats concur with insurance provider requirements.
Prepares clean claims for electronic and / or manual submission.
Accesses Cerner Charge Services to produce and submit claims.
Follows up on submitted claims to ensure timely payment processing.
Contacts insurance providers or TPAs on as needed basis.
Identifies unpaid and partially paid claims and takes the necessary steps for appeal or resubmission.
Processes claim re-submission as required.
Posts insurance payments on the system.
Refers patient related liabilities to the AR Section for processing.
Escalates unresolved claims related issues to the Supervisor - Patient Billing and Revenue Reconciliation
Documents events and interactions using electronic and manual systems.
Maintains billing records in accordance with internal standards.
Preferred Certification : Medical billing certificate or other Revenue Cycle Certificate
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Medical • Doha, Qatar