jayasutha iyyapaazham

medical Auditor at london hospital

• Kuwait
• My current job since January 2020

• Verifies the received insurance claims & related documents from reception or billing clerk.
• Verifies all information mentioned in the claim (services/treatments with the given diagnosis, coverage and exclusions)
• Communicates with all doctors regarding missing required information or filling mistakes or rejection details and the cause.
• Verifies the rejection and prepare the required preventive action plans.
• Updates doctors about the Insurance Exclusions & Policies on a regular basis.
• Prepares report of the medical errors of the claims or other reports/statements as and when needed
• Checks documents and registration status and maintains departmental records and files
• Documents medical claims actions by completing forms, reports, logs, and records.
• Reviews and completes insurance-claim forms and related documents daily
• Answers any inquiries regarding insurance claims, missing documents, error corrections status.
• Protects operations by keeping claims information confidential.
• Adheres to all hospital policies, procedures and guidelines in addition to insurance regulations.
• Payment follows up with insurance company.
• Final report related to insurance claims and sends to finance department and management.