Preapproval Officer
Accumed
مجموع سنوات الخبرة :6 years, 6 أشهر
Coordinates with the Doctors, Nurses, Radiologists, hospital
staff, clerks, and patients in acquiring accurate information for approval
Acquires approvals and guarantee of payments from payers as
per MOH circular resolution No. 1004 year 2015
Provides payers the necessary information to cover patients'
condition
Submits claims to the payer for adjudication
Trains insurance coordinators in various MOH facilities in
Discusses health related concerns to the safety department
meeting
Initiates First Aid treatment and tends to emergency situations
Performs triage to queuing situations
Responsible for procurement of medical supplies.
Arrange transportations for workers in emergency\ies
Conducts trainings on worker's health safety
Supervises safety helpers on emergency procedures
Provide medications for employees as needed Responsible for
monitoring and recording the patient's condition
Assist all injured employees to the nearest hospital
Initiates, updates, and maintains all worker's medical and other
similar records
of Georgia/ Anthem Bluecross
of correcting Remittance Advice and submits to HAAD
and DHA post office
Adjudicates, and adjusts Outpatient, Resubmission, and Paper
claims with ICD-9-CM, ICD-10-CM, CPT and HCPCS codes
Enters Paper claims into the system and assigns ICD-9-CM, ICD-
10-CM, CPT and HCPCS codes
Dispatches, closes and creates bordereau for batches for claims
submission
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