Insurance Coordinator

Position Summary

Summary of Main Duties

•    Understand and comply with network agreements between Insurance Companies and UHS.
•    Verifying the requests from doctors based on the medical conditions and determine whether requires preapproval.
•    Maintain record of approvals for requests that require approvals and update them frequently.
•    Processing claims in the system on daily basis (If required).
•    Auditing the invoices before sending to Insurance Companies.
•    Coordinating with Insurance Companies for queries related to medical approvals, claims etc
•    Reconciling the claims that are short paid/ rejected with valid medical reports.
•    Coordinating with doctors for medical reports and queries from Insurance Companies.
•    Liaise with patients and explain approval or rejection.
•    Undertake all calls regarding approvals from patients and provide appropriate replies.
•    Undertaking the approval and Insurance companies/sponsors as may be applicable.
•    Communicate with patient for approval/rejection status of approvals from sponsoring agency (including Insurance).
•    Communicate with Insurance companies/sponsors and provide required clarification/do follow up of cases.
•    Prepare cost estimate (if assigned) to be sent to insurance companies/sponsoring agencies.
•    Comply with jobs that are additionally assigned by manager from time to time.

Responsibilities

Position Requirements/Qualifications

Requirements/Qualifications

    
•    Bachelor Degree 
•    2 years experience in health insurance.

Position criteria Other Skills/Abilities