Executive Insurance
Executive Insurance Aster Hospital, Al Qusais (Br. Of Aster DM Healthcare FZC)
JOB DESCRIPTION
Claim collection and submission
• Track and update claim form from the assigned pharmacies
• Conducts daily claims audit and make timely corrections
• Prepares reconciliation of internal branch transfer of assigned pharmacies
• Administers total insurance operations
• Updates the resubmitted rejections and the settlements details of claims in the system on a monthly basis
• Submits all documents (claims related) for all pharmacies in all modes ( Paper claims, eclaims and EDI) with supporting documents within agreed timeline per month
• Lists insurance companies and record discount rates
Daily activities
• Reviews claims to make sure that billing requirements are met
• Updates accounts as necessary, answers inquiries, and makes recommendations for resolution
• Responsible for coordinating and supporting initiatives relative to the evaluation, processing, and handling of insurance claims
• Performs data entry and filing to record patient and insurance data
E- claims submission
• Monitors timely online submission by pharmacies
• Follow up with pharmacies for missing documents to Re submit rejected e-claim/paper claim
• Validates and submit e-claims on a monthly basis
Job interactions
• Coordinates with pharmacies for follow up of insurance submission and resubmission
• Works closely with insurance companies for resubmission follow up of claims
Minimum Experience
• 0 – 2 Years
ABOUT US
Aster DM Healthcare Limited is one of the largest private healthcare service providers operating in multiple GCC states and is an emerging healthcare player in India. With an inherent emphasis on clinical excellence, we are one of the few entities in the world with a strong presence across primary, secondary, tertiary and quaternary healthcare through our hospitals, clinics and pharmacies. We have over 20,000 plus dedicated employees across the geographies that we are present in, delivering a simple yet strong promise to our different stakeholders: “We’ll treat you well.” We reach out to all economic segments in the GCC countries through our differentiated healthcare services across the “Aster”, “Medcare” and “Access” brands.
ABOUT THE TEAM
Aster Hospitals, one of the largest private healthcare service providers in GCC, aim to make a difference with our patient-centric approach to medical care and an inherent emphasis on clinical excellence. Currently, Aster Hospitals are located in 4 countries in the GCC specializing in primary, secondary and tertiary healthcare.
These include Aster Hospitals (Mankhool and Al Qusais) in UAE, Aster Al Raffah Hospitals (Muscat, Sohar and Ibri) in Oman, Aster Hospital (Doha) in Qatar and Aster Sanad Hospital (Riyadh) in Kingdom of Saudi Arabia delivering on a simple yet strong promise to its people: “We’ll treat you well.” Overall, Aster DM Healthcare Group has a strong presence in GCC and is an emerging healthcare provider in India with 25 hospitals, 116 clinics and 238 pharmacies manned by 20,500+ workforce (including approx. 1250 doctors on fee for service basis) from across the geographies
Insurance Officer
Follow-up with Tendering, Contracts & Commercial Departments for Insurance related documents.
• Forward the questionnaire & proposal form for all type of insurance policies (CAR, EAR, CPE, PI, W/C, TPL, FG, Money, Fire & Allied Perils, Property All Risks, Motor, Group Health Insurances, etc.) to the insurance company for the quotations.
• Study, analyze, make comparison, negotiate with the insurance company for the premium and get the approval of the Management for the budget/premium.
• Advise to incorporate the necessary clauses, which are required/not required.
• Verify and to amend the policies as and when required.
• Monitor expiry and to advise renewal and extension of the policies.
• Report claims; coordinate with all concerned and to follow-up the same till its settlement.
• Employees Health Insurance - for follow up with Personnel Section, PROs and concerned employees and insurance company.
• Verify the invoices and pass the same to Finance Department for payment.
• Graduate.
• Immediate position
• minimum 10 to 15 years in any Insurance Company or Construction company
Job Types: Full-time, Permanent
Salary: AED12,000.00 - AED18,000.00 per month
Ability to commute/relocate:
• Dubai: Reliably commute or planning to relocate before starting work (Required)
Application Question(s):
• Do you have experience in General Insurance including Property, Health, Fire, Motor etc?
• Are you based in UAE?
• Have you worked with an Insurance Company
Insurance Coordinator | Healthcare
About the Role
Al Futtaim Group Healthcare is looking for Insurance Coder to provide Insurance coding support to the clinic to ensure accurate flow of medical information and patient data between physicians, patients and third-party payers through the use of specific & accurate CPT/ ICD/ DDC codes.
Your will be responsible for the accurate flow of medical information and patient data between physicians, patients and third-party payers.
About the Responsibility
• Responsible for the accurate flow of medical information and patient data between physicians, patients and third-party payers with the use of accurate numeric code to define diagnostics, treatments and procedures and to enter this information into a the facility’s database using medical coding protocol to produce a statement or claim.
• To act as a liaison between the facility and payment parties to investigate the claim, verify its information, and update the database in the instance that a claim is denied by the third-party payer.
• Receive and review patient charts and documents for accuracy
• Ensure that all codes are current and active
• Report missing or incomplete documentation
• Meet daily coding production
• Update and maintain document lists
• Performs accurate charge entries
• Ensure proper coding on provider documentation
• Serves as resource regarding insurance resolutions and coding questions
• Handles co-pays, balances, and charge posting
• Follows coding guidelines and legal requirements to ensure compliance with federal and state regulations.
• Review patient medical records
• Coding treatment information using Current Procedural Terminology (CPT) codes
• Communicating with medical billing specialists to ensure treatment codes are accurately received
• Performs additional duties assigned by Unit In-charge as needed
• Liaise and support other members of the multi-disciplinary team and other agencies relating to patient care, maintaining good communication channels.
• Assess, plan, develop, implement and evaluate programmes to promote health and well-being.
• Be aware of safe guarding policies, both local and national, and implement such policies should it become necessary.
• Recognise and refer patients presenting with holistic health needs, including mental illness.
• Assess clinical conditions, prioritise health problems and intervene appropriately, including initiation of effective emergency care.
• Manage own patient caseload including the interpretation of test results and the ability to act upon these.
About the Requirements
inimum Qualifications and Knowledge:
• Bachelor’s Degree in any stream
• Medical Coding Certificate; RHIT or CPC by AAPC or AHIMA Certificate
• Fluency in English (speak, read and write).
• Arabic speaking skills will be an added advantage.
• Computer Literacy skills is required.
Minimum Experience:
Minimum 4+ years experience in a similar role.
Job-Specific Skills:
• Understanding of medical terminology, anatomy and physiology
• Ability to work independently or as an active member of a team
• Strong computer skills in data entry, coding, and knowledge of Electronic Medical Record software; Microsoft Office Suite
• Accurate and precise attention to detail
Behavioural Competencies:
• Excellent presentation and analytical skills
• Exceptional written and oral communication skills
• Good decision making skills
• Strong operational thinking skills
• Critical Thinking
• Conflict Management
