insurance technical auditor cum incharge
salamat medical group
Total years of experience :6 years, 6 Months
here is my responsibility -
At present I am working in insurance Dept from 15/11/2016 to till now as a Incharge of Insurance Section we have more and less all insurance co( Tawuniya, Bupa, Medivisa, EC, Gosi, Mednet, Malath, Axa, Nextcare, Saico, metlife, Tcs, over all we have all co.
I have coding Responsibility.
Communicating with the co and Patient if require regarding the Insurance card, eligibility etc.
My responsibility here is extensive Audit of patient bill includes
Checking eligibility of the patient, Checking, Iqama and Insurance ID validity, Ucaf of the Patient.
Full review of Ucaf (like diagnosis code, date, Dr Stamp, and examination of BP, Temp, Pulse).
Checking criteria of Approval of require diagnosis like, lab report, Radiology report, medicine and the limit of the patient for approval.
Supervising, controlling, coordinating, and directing regarding work with our fellow team of Insurance section.
Cross Checking the bill with the Statement for Sending it to the insurance co for Final Claim.
Communicating with the various insurance co for the money recovery.
we accept the audit assignment from the co and we do audit of the financial statement of the co(all income and expenditure, asset and liabilities) so that co can submit there financial statement after the independent audit of financial statement by the auditor
my role is to lead the team divided the work between the colleague and do the audit of client check there all transaction, purchase, sales register, expenditure, salary, no of workers, stock comparing the position from previous audited statement and so onnnnn