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Seniority (Health care, medical)
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Oasis Healthcare Group Limited
Health care + 1 more
Description
Skill & Experience
- Diploma in Accounting, Finance, or a related business field.
- Minimum of 2 years’ experience in hospital billing or insurance claims management.
- Strong understanding of healthcare billing systems and claim processing procedures.
- Knowledge of SHA and private insurance claim guidelines.
- Proficiency in Microsoft Excel and hospital management systems.
- Strong analytical and reconciliation skills.
- High level of accuracy and attention to detail.
- Good negotiation and follow-up skills.
- Strong communication and interpersonal skills.
- Ability to work under pressure and meet strict submission deadlines.
Responsibilities
- Prepare, verify, and submit insurance claims (SHA and private insurers) accurately and within stipulated timelines.
- Review patient files to ensure completeness of documentation before claim submission.
- Reconcile claims submitted against payments received and identify variances.
- Follow up on pending, rejected, or partially paid claims to ensure timely reimbursement.
- Analyze claim rejection trends and recommend corrective measures.
- Liaise with insurers, corporate clients, and internal departments to resolve claim-related discrepancies.
- Maintain accurate claims records and update tracking systems regularly.
- Ensure compliance with insurer contracts, pre-authorization requirements, and billing guidelines.
- Support revenue cycle management by coordinating with billing, pharmacy, laboratory, and clinical departments.
- Generate periodic claims performance reports (submission rates, rejection rates, aging analysis).
- Assist in preparing documentation required for insurer audits and reconciliation meetings.
- Monitor credit control and aging of receivables from insurance and corporate accounts.
- Ensure confidentiality and secure handling of patient financial data.
- Participate in continuous improvement initiatives to strengthen claims management processes.
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