SENIOR SPECIALIST
Total years of experience :15 years, 9 Months
• Claims Management.
• Assist with filing claims and initial review.
• Manage all aspects of claims processing.
• Follow insurance claims to close.
• Conduct quarterly insurance claims review with Finance Team.
• Certificate of Insurance Support as necessary.
• Provide support for certificates of insurance requests for all new locations.
• Assist in Policy Renewal.
• Maintain Statement of Values for all locations
• Perform special projects and various ad-hoc requests as needed
and Responsibilities:
Responsible for duties related to managing, organizing, implementing and coordinating the insurance programs and activities associated with all aspects of Medical Insurance.
This includes claim investigations as well as the timely and effective communication of all insurance claims. In addition to supporting claims and risk management.
Support various finance and treasury initiatives Performs orientation and enrolment of eligible SAFARI employees for health, dental, life, flexible spending accounts and optional insurance coverage’s.
Initiates changes in individual insurance coverage, notifies payroll of deduction changes. Removes employees from programs at termination and notifies employees of their rights.
Plans and co-ordinates activities of employee benefit plans such as maintenance of records, contributions, employee eligibility, benefit payment, administrative expenditures, and related matters. Responsible for implementing the insurance policies of SAFARI and Department Heads with respect to insurance matters and employee benefits.
Prepares billings to retirees, employees for health insurance premiums. Receives premium payments and prepares for deposit. Analyses expenses and bills departments for health, liability and worker's compensation insurance costs.
Assists and acts in a confidential capacity in employee benefit matters regarding formulation, determination and effectuation of the management policies regarding labour relations.
and Responsibilities:
• Coordinating, liaising and networking between insurance companies regarding eligibility, payments, approvals, reconciliation and other requirements.
• Responsible for filing and tracking insurance claims and informing patients of their claims status
• Process insurance and disability claims in a timely manner
• Prepares insurance forms and associated correspondences
• Entertains patients’ queries regarding unpaid balances
• Liaise with patients regarding their eligibility and entitlements
• Maintains strict confidentiality related to medical records and other data
Overall supervision of division.
Handling customer enquiries
Supervising & Generating bills (TPA, Admission, Cash/ Credit, Discharge)
Treating customers/attendants/patients professionally
Motivating the employees.
Training the employees.
Bringing new developments in the division.
Finding out the training needs.
Handling all major patient care related issues
Maintaining patients records on daily basis & Making arrangements for Seminars
and Responsibilities:
Greet patients and visitors in a courteous and friendly manner.
· Screen calls, arranges appointments and referrals.
· Prepares new records, re-files, and maintains records.
· Type correspondence, reports, memos, and forms as requested by physician and
Practice manager.
· Some transcription of medical notes.
80%
80%