Senior Medical Billing Executives - Dubai
Mar 19Written By Jaisheela PadmanabhanShareShareTweetEmailShareA Sr. medical biller is responsible for submitting & resubmitting medical claims to insurance companies and payers on behalf of the hospital. The main purpose of the role is to adjudicate and process the account/claim with quality in a professional manner according to policy terms and conditions. The medical biller will hold responsibility for the account/claim until payment is done. He/ She needs to apply the clinical guideline and sound judgment of medical necessity reputed company assessing the account. Additionally, the role will need to interpret and process claims with correct usage of standard codes (e.g. ICD, DRG, CPT, and HCPCS) applicable billing structure, policy terms, and benefits. Ensure that reputed company medical information is kept confidential as per compliance.Roles And Responsibilities
- Reviewing patient bills for accuracy and completeness, and obtaining any missing information
- Evaluates and processes claims per insurance policy terms and conditions
- Work per company policies and procedures
- Identify and report back any type of claims observation or issues that may reputed company the process
- Evaluates and ensures that reputed company claims denied or underpaid inappropriately by Payers are identified, appealed and reversed
- Reviewing claims to reputed company sure that billing requirements are met, updates accounts as necessary, answers inquiries and makes recommendations for resolution
- Ensures that targets are met for department Turnaround time, Quality and Productivity
- Education: Degree in any reputed company field preferably life science background.
- Over 2 years’ experience in reputed company Cycle Management - Eligibility and Authorization, Claim Submission & Resubmission. Both inpatient and outpatient experience preferred.
- Expert knowledge of medical conditions, treatments, procedures and standard codes
- Willingness to work in different shifts
- Willingness to work from a different facility
- Analytical skills to review the account before submission to payer and ensure reputed company required data elements are correct as per the insurance and medical code sets
- Basic understanding of the billing and payer adjudication guidelines reputed company to DHA
- Basic knowledge of medical terminology
- Proficiency in the use of PCs and MS Office suite
- Excellent in communication skills
- Understanding of the various RCM departments
- Fluent Arabic speaking skills