Job
Description
Roles and Responsibilities
- Check over insurance claims forms as they are submitted and review each section for accuracy and completeness
- Confirm that the patient and the treatment or prescription are covered parts of the insurance plan by researching the plan details using a computerized database or calling the physicians office
- Submit each insurance claim after verification for final processing via an electronic submittal form system and review the reception of the claim with a final check
- Interpret the language in the overview of benefits summary explanation for the insurance policy and apply interpretation to the claims review process
- Update policy forms and claims information when insurance coverage changes have occurred and notify appropriate parties of the changes when necessary
- Maintain knowledge of all appropriate medical insurance coverage laws in the local, state and federal jurisdiction area when reviewing claims submissions
- Follow all required medical privacy laws when discussing private information about patients with physicians, healthcare managers or other staff members in the insurance agency
Required Candidate profile
- Good in MS excel
- Required experience in health insurance and TPA
- Knowledge of TPA claim process
- BDS,BPT,MPT,BHMS,BUMS BAMS, can apply only.
Perks and Benefits
Interested Candidate share resume at Sapna.chauhan@careinsurnace.com