Job Description

Job Specifications:

u Experience: 0-2 Years

u Graduation with min 6 months certification in Computer Course.

Key Responsibility & accountability

1. Insurance Billing and Claim Submission:

Process and submit insurance claims for patients covered under government insurance programs, including ECHS, CGHS, and ESI.

Ensure accurate and complete documentation, coding, and billing of services provided by the hospital.

Verify patient eligibility and benefits under the respective government insurance programs.

Review claims for errors or discrepancies, resolve issues, and resubmit corrected claims as necessary.

Follow up on pending claims and denials, working with relevant departments to address and resolve any issues.

2. Reimbursement Maximization:

Stay updated on the reimbursement policies and guidelines of ECHS, CGHS, ESI, and other relevant government insurance programs.

Collaborate with the billing and coding team to ensure proper coding and documentation to maximize reimbursement.

Identify opportunities for improving reimbursement rates and communicate them to the appropriate stakeholders.

Analyze claim denials, identify trends or patterns, and implement strategies to minimize future denials.

3. Compliance and Regulation:

Ensure compliance with government regulations, policies, and documentation requirements for each government insurance program.

Stay informed about changes in reimbursement rates, coding guidelines, and documentation standards.

Conduct regular audits of billing and coding processes to ensure adherence to government program requirements.

Collaborate with the compliance team to address any compliance issues and implement corrective actions.

4. Government Agencies and Insurance Provider Relations:

Serve as a liaison between the hospital and government agencies, insurance providers, and third-party administrators for government insurance programs.

Establish and maintain effective communication channels with relevant stakeholders.

Respond to inquiries, resolve issues, and provide necessary documentation or information as requested.

5. Reporting and Documentation:

Generate and maintain accurate records of insurance billing activities, including claims submitted, reimbursements received, and denials/appeals.

Prepare regular reports on key performance indicators, claim processing metrics, and reimbursement rates.

Collaborate with the billing and coding team to ensure proper documentation and record-keeping.

If interested please send your resume on hr@nkshospital.com or call on 8130894501

Job Type: Full-time

Pay: ?20,000.00 - ?30,000.00 per month

Experience:

• total work: 1 year (Preferred)

Work Location: In person