Submission Officer (Corniche Hospital)

•  Monitoring compliance to insurance company's terms and conditions    Monitoring compliance the rules and the contractual terms and agreement with the insurance companies


• Ensuring compliance by the facility pricing structure and the rules for the different patient categories (including self-payer) with implementation


• Assisting in collecting and processing claims


• Validating the claimed outpatient services (Laboratory, Radiology and Pharmaceuticals)


• Checking the claim invoices (inpatient and outpatient)


• Generating and regenerate the missed and incorrect invoices


• Processing each claim in the system


• Attending answering about financial matters, to patient and Specialty clinics inquiries


• Preparing statement of accounts


• Following –up the claims submission to the insurance company


• Ensuring that all insurance documents been properly filled and claiming related amount


• Comparing the cancelled receipts received from cashiers on monthly basis to ensure that there are no manipulations in canceling transaction


• Resubmitting the rejected claims with a wrong reason or without reason and unpaid claims


• Providing customer service and support    Responding to verbal and written financial inquiries in a timely manner


• Providing technical expertise in identifying potential financial/Accounting issues


• Discussing with Manager/Senior Officer, if necessary, before recommending solutions after obtaining and verifying information
  
  Contributing to team effort    Participating in cross-functional teams and committees as appropriate


• Serving as a subject matter expert in regards to inventory accounts, payments and accounting systems


• Developing and enhancing team procedure manual and processes and discussed with Manager/Senior Officer

Qualification: Bachelor's Degree or Diploma in any related field (medical/health science)

Special Certificate: AAPC or AHIMA Certification

Required: 2-4 years of relevant progressive experience in a similar role 

Desired: Experience in a large healthcare facility