Medical Billing Associate

Key requirements and attributes

• Be a Clinical Officer at Penda.
  
• 1 year working experience at Penda. 
  
• A great champion of Penda Way demonstrating strong leadership skills.
  
• A track record of great performance across all areas from the PR.
  

Key requirements and attributes

• Be a Clinical Officer at Penda.
  
• 1 year working experience at Penda. 
  
• A great champion of Penda Way demonstrating strong leadership skills.
  
• A track record of great performance across all areas from the PR.
  

• Thoroughly review claims for errors, accuracy, and completeness, rectifying any issues before submission to insurance companies. Provide direct feedback to medical centers/providers on identified errors.
  
• Coordinate pre-authorization and eligibility verification processes, ensuring compliance with insurance guidelines. Train medical center staff on insurance guidelines and provide consultation for compliance.
  
• Ensure timely dissemination of changes and communications from insurance partners to all medical centers. Maintain accurate record-keeping of invoices and communicate limits/exclusions to service points based on insurance guidelines.
  
• Support medical centers by identifying capacity gaps and providing training in medical billing. Liaise with the credit team to review disputed claims and provide clinical justification for appeals to insurance.
  
• Professionally respond to queries from insurance partners or medical centers regarding billing. Timely circulate memos to clinicians and clinical coordinators on new insurance guidelines.
  
• Scrutinize rejected claims related to clinical issues, providing guidance and coaching to medical centers to minimize claim denials. Submit invoices through designated portals for processing.