Role Purpose- Ensure accuracy of daily revenue cycle management clinical & administrative transactions by effective reconciliation in collaboration with all stake holders, process billing and collection from third party payers. Liaise and follow up with third party, post, consolidate and generate charges and submit bills to third party payers for payment.
- Confirm patient insurance coverage, eligibility, benefits, and pre-requisite information/documents.
- Review patient bills for accuracy and completeness before submission.
- Prepare and submit accurate insurance claims to payers, including managing through Electronic Medical Record (EMR) & Revenue Cycle Management System (RCM)
- Follow up on unpaid, rejected, or denied claims and resubmit them as needed.
- Generate, review, and send accurate invoices and statements to clients/patients.
- Post payments, adjustments, and refunds, and reconcile accounts, ensuring timely collection.
- Liaise with internal system support team, stakeholders, patients, or payors to streamline and smooth functioning of RCM processes
- Maintain up-to-date knowledge of billing software and insurance guidelines.
- Generate and analyze billing reports for management review.
- Responsible for providing service estimates to various stake holders based on the treatment plan.
- Generate daily billing revenue & collection reports for circulation to accounts officer.
- Daily/Weekly reporting on all unpaid/uncollected payment and follow up.
- Track all outgoing invoices and prepare quarterly statement of accounts for outstanding payment.
Minimum 5 years of direct and relevant experience in a full-fledged automated healthcare insurance echo system. Higher Diploma/Graduation/associate degree in finance, or healthcare administration preferred.
Familiarity with Qatar Ministry of Public Health insurance regulations and coding standards. Certification in medical billing and/or coding is an added advantage Technical Skill: Proficiency in Revenue Cycle Management software, electronic medical records (EMR), and Microsoft Office (Excel/Access/Word/PowerPoint).