Role Summary:
The
medical billing associate role entails ensuring that all medical billing
requirements from different partners are adhered to, and that all the requisite
clinical and patient documentation is well captured in every invoice.
Responsibilities:
- 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.
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.
How To Apply
