Submission & Resubmission Officer

• DUTIES AND RESPONSIBILITIES

  • Review and Audit Medical Claims to ensure their accuracy.
  • Resubmission of rejected claims
  • Ensure that the agreed price list and provider manual from insurance companies are followed for billing the service to the respective payers.
  • Ensure that the Billing officers are updated on time with the rejections and corrective action is taken to avoid such instances in future
  • Handling the Resubmission of rejected claims, follow up with respective doctors for justifying the claims if necessary and prepare them for resubmission.
  • Submit the claims with proper codes and format to insurance companies within the stipulated time.
  • Performs any other jobs or duties assigned by the HOD from time to time within the scope of job title.

OSH ROLES & RESPONSIBILITIES

GENERAL

• Comply with reasonable OSH instructions, policies and safe working procedures

  • Use of appropriate personal protective equipment and safety systems.
  • Be familiar with emergency and evacuation procedures
  • Not willfully or recklessly endanger anyone’s health and safety
  • Assist with the preparation of risk assessments
  • Report OSH Hazards, incidents, Near misses and issues
  • Reduce, Reuse, Recycling of waste as much as possible
  • Attend all OSH Trainings, awareness programs and mock drills.
  • Participates in the OSHMS audits, inspections, ensuring standards are maintained

Additional duties/responsibilities (related to ADHICS) assigned to this position in clear, concise language

Health Information Literacy and Skills:

• Adhere to information systems policies and procedures as required by Health Care Organization.

  Privacy, Confidentiality of Health Information:

  • Follow security and privacy policies and procedures to the use of networks, including intranet and Internet.
  • Follow confidentiality and security measures to protect electronic health information.
  • Maintain data integrity and validity within an information system.
  • Report any possible breaches of confidentiality in accordance with organizational policies.

  Health Information/Data Technical Security:

• Apply departmental and organizational data and information system security policie

  Basic Computer Literacy Skills:

  • Use basic word processing, spreadsheet and desktop presentation applications as applicable to your work.
  • Demonstrate proficiency in Windows operating environment.
  • Demonstrate use of email, addressing, forwarding, attachments, netiquette.

BCP ROLES & RESPONSIBILITIES

3.26 Responsibilities of staff (including all contractors) are:

3.26.1 Achieving an adequate level of general awareness regarding business continuity Being aware of the contents of their service areas disaster recovery plan and any specific role or responsibilities allocated.

• Participating actively in the business continuity programme when required

  • Ensuring information governance standards continue to be applied to data and information during an incident

DUTIES AND RESPONSIBILITIES

• Review and Audit Medical Claims to ensure their accuracy.
• Resubmission of rejected claims.
• Ensure that the agreed price list and provider manual from insurance companies are followed for billing the service to the respective payers.
• Ensure that the Billing officers are updated on time with the rejections and corrective action is taken to avoid such instances in future.
• Handling the Resubmission of rejected claims, follow up with respective doctors for justifying the claims if necessary and prepare them for resubmission.
• Submit the claims with proper codes and format to insurance companies within the stipulated time.
• Performs any other jobs or duties assigned by the HOD from time to time within the scope of job title.

OSH ROLES & RESPONSIBILITIES

GENERAL

• Comply with reasonable OSH instructions, policies and safe working procedures.
• Use of appropriate personal protective equipment and safety systems.
• Be familiar with emergency and evacuation procedures.
• Not willfully or recklessly endanger anyone’s health and safety.
• Assist with the preparation of risk assessments.
• Report OSH Hazards, incidents, Near misses and issues.
• Reduce, Reuse, Recycling of waste as much as possible.
• Attend all OSH Trainings, awareness programs and mock drills.
• Participates in the OSHMS audits, inspections, ensuring standards are maintained.

Additional duties/responsibilities (related to ADHICS) assigned to this position

Health Information Literacy and Skills

• Adhere to information systems policies and procedures as required by Health Care Organization.

Privacy, Confidentiality of Health Information

• Follow security and privacy policies and procedures to the use of networks, including intranet and Internet.
• Follow confidentiality and security measures to protect electronic health information.
• Maintain data integrity and validity within an information system.
• Report any possible breaches of confidentiality in accordance with organizational policies.

Health Information/Data Technical Security

• Apply departmental and organizational data and information system security policies.

Basic Computer Literacy Skills

• Use basic word processing, spreadsheet and desktop presentation applications as applicable to your work.
• Demonstrate proficiency in Windows operating environment.
• Demonstrate use of email, addressing, forwarding, attachments, netiquette.

BCP ROLES & RESPONSIBILITIES

• Achieving an adequate level of general awareness regarding business continuity.

• Being aware of the contents of their service areas disaster recovery plan and any specific role or responsibilities allocated.

• Participating actively in the business continuity programme when required.

• Ensuring information governance standards continue to be applied to data and information during an incident.

• Qualification: Medical/paramedical (Nursing, Pharmacy, etc.) graduate from a recognized university.

• Experience: Experience in Insurance Claims management/adjudication (minimum 2 years).

• Preferred Skill: Experience in Medical Coding is preferable.

• Language: Excellent command of oral and written English.