ديفيا Maneesh

Medical insurance and billing team lead في Orthocure Medical Centre

• الإمارات العربية المتحدة - دبي
• أشغل هذه الوظيفة منذ نوفمبر 2015

• Coordinating, liasing and networking between insurance companies regarding eligibility, payments, approvals, reconciliation and other requirements.
• Analyse and examine claim forms and other records to determine insurance coverage on a daily basis in order to reduce rejection to minimum possible.
• Manages to abstract pertinent information from patient records and translates the information into diagnostic and procedural codes in accordance with the clinical coding system followed by Dubai Health Authority.
• Queries Physicians when code assignments are not straight forward or documentation in the record is inadequate.
• Billing insurance claims and enter the data into the eclaim and submitting the claims to the concerned insurance companies/TPAs in a timely manner via DHPO.
• Also manages to do resubmissions in eclaim and handle payment transactions, reconciliations, issuing invoices etc.
• Attend calls and provide support and guidance for clinic staff for any query regarding insurance billing, selection of ICD 10/CPT codes etc.
• Explaining coverage of medical benefits to patients when required.
• Maintaining and updating the latest information, procedure, protocols from the insurance companies and circulating among the group.
• Follow ups with insurance companies/TPA’s for the purpose of policy updates, new contracts, revision in contracts etc and also prepare management analysis and reports.
• Attending seminars and meetings related to eClaims and insurance policies and protocols to ensure implementation of all new requiremets to maintain compliance.
• Supervising, supporting, training and guiding other staffs in the team.
• Evaluating, correcting and approving bills.