insurance assistant
International medical company
Total years of experience :7 years, 7 Months
As an Insurance Assistant manage medical claims collected from 108 Kulud Pharmacy Branches. Properly coding services procedures, diagnoses and treatments. Preparing and sending invoices or claims for payment monthly basis.
• Responsible for answering phones, and emails.
• Process and review insurance documentation and ensure all documents are complete.
• Maintaining patient/customer records monthly basis.
• Receiving and checking monthly the medical claims from each pharmacy.
• Encode all the received Medical Insurance Claims from the Kulud Pharmacy in Excel form/ Portal and submitted to Medical Insurance Companies.
• Checking the dispensed medicine as per diagnosis written in the claim form.
• Checking benefits and limits, copay, approval validities etc.
• Follow up with the concerned pharmacist about the discrepancies of medical claims from the Kulud pharmacy and get the needed feedback and make the correction on the system.
• Communicating with insurance companies through emails and call to resolve the issues.
• Assigning ICD 10 codes.
• Reconciliation of encoded vs system
• Follows up with all insurance companies for the release of payments