insurance coordinator and business development/ clinic operation manager
precision health clinix / AGBL Group
مجموع سنوات الخبرة :8 years, 7 أشهر
precision health clinix - Dubai
August 2023 to Present
Insurance and Business Development/ clinic operations
Oversee the comprehensive process of insurance claims, including evaluation, processing, submission, and follow-up, ensuring timeliness and accuracy.
Serve as the primary liaison between patients, healthcare providers, and insurance companies, resolving any issues or discrepancies that arise
Patient Data Confidentiality:
Enforce strict adherence to HIPAA and other relevant regulations concerning patient data security.
Analyze market trends and competitor strategies to recommend business improvements and opportunities for growth.
Develop and present business development reports during management meetings, providing strategic direction for clinic and lab expansion.
Administrative Proficiency:
Streamline interdepartmental communications, ensuring smooth operation flows and enhanced teamwork efficiency.
Manage administrative tasks with a high degree of excellence
Oversee the timely and accurate preparation of all insurance-related forms and correspondences.
Audit & Compliance:
Conduct thorough audits for all insurance claims, especially non-ERX transactions, to ensure compliance and accuracy.
Continuously update and refine compliance protocols in response to new regulatory requirements.
Training & Development:
Provide training for new staff on insurance processes and clinic's operating procedures.
procurement
Preparing plans for the purchase of equipment, services, and supplies.
Following and enforcing the company's procurement policies and procedures.
Reviewing, comparing, analyzing, and approving products and services to be purchased.
Managing inventories and maintaining accurate purchase and pricing records.
Maintaining and updating supplier information such as qualifications, delivery times, product ranges, etc.
• Working on DHA Covid project related to insured and non insured patients.
• Assigns and verifies Diagnosis Related Group (DRG) assignments using Codemaster--computerized code book software.
• Interact on a daily basis with doctors, nurses, and other healthcare professionals to insure accuracy and completion of billing.
• Post charges utilizing a strong understanding of medical terminology, ICD 9 and CPT codes and interpret medical explanation of benefits.
• Experience in registration in healthcare, business office and physician billing, with reimbursement and collections.
• Investigate pended claims for authorization, conduct timely review of authorization module and reconcile for claim payment.
• Prepare and submit billing data and medical claims to insurance companies.
• Perform data entry and filing to record patient and insurance data.
• Prepare bills and invoices, and document amounts due to medical procedures and services.
• Confirm insurance coverage with insurance companies by diagnostic and procedural codes.
• Getting approvals for medical procedure.