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Submission & Resubmission Officer

Job Description - Submission & Resubmission Officer

Description

Accurately uploading and verifying claims documentation, coordinating with medical coders to resolve discrepancies, generating status reports, and ensuring timely escalation of issues



Responsibilities
  • Upload claims documents and data into the claims management system accurately and promptly.

  • Verify accuracy of claim forms and related documentation before uploading such as checking the card number with given formula, verifying the TPA / Policy is entered correctly and if any Dummy approval was entered.

  • Coordinate with Medical Coders to resolve discrepancies or missing information.

  • Assist in generating reports related to claims status and data uploads.

  • Identify and escalate issues related to claims documentation or data entry to the supervisor.

  • Perform other administrative duties related to claims processing as assigned.



Qualifications
  • Bachelors or Diploma - Any Medical discipline or related fields. 

  • with CPC/ AAPC coding certificate 



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