Associate.Insurance

Claim collection and submission

Track and update claim form from the assigned pharmacies

Conducts daily claims audit and make timely corrections

Prepares reconciliation of internal branch transfer of assigned pharmacies

Administers total insurance operations

Updates the resubmitted rejections and the settlements details of claims in the system on a monthly basis

Submits all documents (claims related) for all pharmacies in all modes ( Paper claims, eclaims and EDI) with supporting documents within agreed timeline per month

Lists insurance companies and record discount rates

Daily activities

Reviews claims to make sure that billing requirements are met

Updates accounts as necessary, answers inquiries, and makes recommendations for resolution

Responsible for coordinating and supporting initiatives relative to the evaluation, processing, and handling of insurance claims

Performs data entry and filing to record patient and insurance data

E- claims submission

Monitors timely online submission by pharmacies

Follow up with pharmacies for missing documents to Re submit rejected e-claim/paper claim

Validates and submit e-claims on a monthly basis

Job interactions

Coordinates with pharmacies for follow up of insurance submission and resubmission

Works closely with insurance companies for resubmission follow up of claims

Minimum Experience