Mara Jessa أوليفر

Medical Insurance Coordinator في Al Jazeera Hospital

• المملكة العربية السعودية - الرياض
• أشغل هذه الوظيفة منذ نوفمبر 2021

• Responded to correspondence from insurance companies.
• Supported smooth admission and discharge processes by handling associated documents.
• Reviewed provider coding information to report services and verify correctness.
• Maintained knowledge of benefits claim processing, claims principles, medical terminology and procedures.
• Used administrative guidelines as resource or to answer questions when processing medical claims.
• Compiled electronic patient records covering conditions, treatments and diagnoses.
• Input data into computer programs and filing systems.
• Send approval requests through insurance portals or insurance fax system.
• Answer queries regarding approval requests and update patients about approval request status.
• Send SMS to the patient regarding approval status.
• Coordinate with physicians to get further information or report if requested by insurance companies.
• Update approval status in Hospital HIS system such as send, waiting, approved rejected.
• Update HIS with details about rejection or partially approved requests.
• Enter approved cost, Length of stay approved, partial approvals or rejected items in HIS system with detailed notes for admitted patients
• Inform case manager, approval manager and admission manager regarding immediate stoppage of patient coverage during inpatient stay.
• Communicate with Rowing insurance doctors and update inpatient approval status.
• Confirm approved services, with real invoice after service to make sure obtained adequate approval.
• Eradicate pending approvals after requested from physicians and report unattended approvals to approval manager.
• Prepare daily report for all approval activities.
• The claim document should be handed over to business center department daily basis.
• Refers all inquiries for preparing response for the financial rejections done by the contracted companies to Head of Rejection Management.
• Ensures proper flow of documents supporting the changes and reporting the short comings to the concerned.
• Reviewing all contracts from the financial point of view prior to accreditation from the administration.
• Correlation between Finance, Patient Services, Pharmacy and other concerned departments offering the service about application of the terms of contracts and documents
• Performs additional tasks and duties as assigned by Superiors.