Medical Insurance Coordinator
6 days ago
Promote the mission, vision, and values of the organization Taking care of the insurance department (claims, approvals, network factor negotiations, regulations of the insurance industry). Dealing with Medical insurance companies for payments and denials. Identification of potential insurance companies and corporate associates and make business proposals Review of agreements, renewal of contracts, negotiations, network selection and empanelment. Answering queries and coordinates with the Finance department, General manager and Medical Director for necessary clarifications for billing and reconcilliation purposes. Review daily accounts that are ready to be billed. Initiate correction on all claims with errors by the designated time. Ensure the claim submission and resubmission within contracted period to ensure maximum recovery to avoid denials Provide training on insurance policies and protocols to insurance and front office staffs. Design, update and implement policies, procedures and practices to ensure the efficiency and effectiveness of the insurance department. Responsible for management of approval process, follow-up and negotiate on difficult approvals. Responsible for the collection of insurance receivables: contact insurance and corporate associates regularly, follow up on payments and maximize collection efficiency. Initiate collections on past due receivables, resolve any discrepancies, perform disallowance reconciliation with insurance companies.
Evaluate the disallowance reasons; identify the improvement areas, and implement the changes. Regularly submit reports to the management on submission of claims, remittance, and resubmission, and insurance receivable ageing. Prepare the department for an yearly audit process.
Ability to commute/relocate:
- Doha: Reliably commute or planning to relocate before starting work (preferred)
**Education**:
- Bachelor's (preferred)
**Experience**:
- Medical Insurance Coordinator: 2 years (required)
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