insurance claims analyst

Sanadk Services

Job Summary We are seeking a detail-oriented and knowledgeable Insurance Analyst to join our team. The ideal candidate will have a strong background in managed care, medical office operations, and insurance verification. This role involves analyzing insurance claims, ensuring compliance with HIPAA regulations, and maintaining accurate medical records. The Insurance Analyst will play a crucial role in facilitating effective communication between healthcare providers, patients, and insurance companies.Responsibilities<ul><li>Review and analyze insurance claims for accuracy and completeness.</li><li>Verify patient insurance coverage and benefits prior to services rendered.</li><li>Maintain compliance with HIPAA regulations while handling sensitive patient information.</li><li>Utilize CPT coding, ICD-9, and ICD-10 coding systems to ensure proper billing practices.</li><li>Collaborate with medical staff to resolve any discrepancies in medical records or coding.</li><li>Assist in the management of medical terminology and documentation within the office.</li><li>Provide support for both dental and medical office operations as needed.</li><li>Prepare reports on claims processing and outcomes for management review.</li></ul>Qualifications<ul><li>Proven experience in managed care and medical office settings is preferred.</li><li>Strong understanding of HIPAA regulations and compliance standards.</li><li>Proficiency in CPT coding, ICD-9, ICD-10, and general medical coding practices.</li><li>Familiarity with medical terminology and the ability to interpret medical records accurately.</li><li>Excellent organizational skills with attention to detail.</li><li>Strong communication skills for effective interaction with healthcare professionals and patients.</li><li>Previous experience in insurance verification is highly desirable.</li><li>Experience in a dental office environment is a plus but not required. Join our dedicated team of professionals committed to providing exceptional service in the healthcare industry. Your expertise as an Insurance Analyst will contribute significantly to our mission of delivering quality care while ensuring efficient insurance processes.</li><li>Able to communicate in Arabic and English ( Bi-lingual)</li></ul>Job Type: Full-timePay: QAR1,300.00 - QAR2,800.00 per month

Insurance Analyst

Med-Metrix

Job Purpose
 The Medical Claims Analyst is responsible for collections, account follow up, billing and allowance posting for the accounts assigned to them.
 
Duties and Responsibilities
 <ul>
<li>Follow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or websites</li>
<li>Meets and maintains daily productivity/quality standards established in departmental policies</li>
<li>Uses the workflow system, client host system and other tools available to them to collect payments and resolve accounts</li>
<li>Adheres to the policies and procedures established for the client/team</li>
<li>Knowledge of timely filing deadlines for each designated payer</li>
<li>Performs research regarding payer specific billing guidelines as needed</li>
<li>Ability to analyze, identify and resolve issues causing payer payment delays</li>
<li>Ability to analyze, identify and trend claims issues to proactively reduce denials</li>
<li>Communicates to management any issues and/or trends identified</li>
<li>Initiate appeals when necessary</li>
<li>Ability to identify and correct medical billing errors</li>
<li>Send appropriate appeals, accurate requesting information, supporting documentation, and effective communication to complete recovery process</li>
<li>Understanding of under or over payments and credit balance processes</li>
<li>Assist with special A/R projects as needed. Analytical skills and the ability to communicate results are required</li>
<li>Act cooperatively and courteously with patients, visitors, co-workers, management and clients</li>
<li>Work independently from assigned work queues</li>
<li>Maintain confidentiality at all times</li>
<li>Maintain a professional attitude</li>
<li>Other duties as assigned by the management team</li>
<li>Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards</li>
<li>Understand and comply with Information Security and HIPAA policies and procedures at all times</li>
<li>Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties</li>
</ul>
Qualifications
 <ul>
<li>Completed at least High School education</li>
<li>Minimum 1 year of Healthcare Account Receivable/Collections in a BPO setting or environment (claims payments processing, claims status and tracking, Medical Billing, AR Follow ups, Denials and Appeals-outbound healthcare providers)</li>
<li>Experienced on medical billing/ AR Collections</li>
<li>Background in calling insurance (Payer) to verify claim status and payment dispute</li>
<li>Strong interpersonal skills, ability to communicate well at all levels of the organization</li>
<li>Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses</li>
<li>High level of integrity and dependability with a strong sense of urgency and results oriented</li>
<li>Excellent written and verbal communication skills required</li>
<li>Gracious and welcoming personality for customer service interaction</li>
</ul>
Working Conditions
 <ul>
<li>Must be amenable to work night shifts</li>
<li>Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.</li>
<li>Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress.</li>
<li>Work Environment: The noise level in the work environment is usually minimal.</li>
</ul>
Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.

Medical Claims Analyst

EPIC Insurance Brokers & Consultants

<div>Come join our team!

There are many reasons why EPIC Insurance Brokers &amp; Consultants has become one of the fastest-growing firms in the insurance industry. Fueled and driven by capable, committed people who share common beliefs and values and &quot;bring it&quot; every day, EPIC is always looking for people who have &quot;the right stuff&quot; &ndash; people who know what they want and aren't afraid to make it happen.

Headquartered in San Francisco and founded in 2007, our company has over 3,000 employees nationwide. With locations spread out across the U.S., our local market knowledge and industry expertise helps support our clients' regional and global needs. We have grown very quickly since our founding, and we continue to see growth and success thanks to our hard-working and growth-minded employees.

Our core values are: Owner mindset, Inspire trust, Think big, and Drive results. If these values and growth align with what you're looking for in your next career? Then consider joining our amazing team! 


JOB OVERVIEW:

The hiring team for this role coordinates placement of our clients' surety bonds and programs with multiple insurance carriers. The team is looking for an individual with an accounting and/or insurance background to be a Surety Invoice Analyst. This role will assist our team with processing invoices and client management. On the job training will be provided. 


LOCATION: Atlanta (Sandy Springs) GA - This is mostly a remote, work-from-home role. HOWEVER candidates must be local to the Atlanta area &amp; be able to come into the Sandy Springs, GA office as needed, particularly during the training &amp; onboarding period. 


WHAT WE'RE LOOKING FOR:
<ul>
<li>Experience working in accounting role, performing accounts payable (invoicing), accounts receivable, reconciliations, and other standard accounting functions (at least 1+ years' of experience).</li>
<li>Curiosity and an eagerness to learn! Insurance industry experience is nice to have but not required. The team can teach the important aspects of the industry, but ideal candidates will love learning, be a self-starter.</li>
<li>Candidates with strong, professional communication skills &ndash; both written and verbal.</li>
<li>High attention to detail, and the ability to learn and understand software systems quickly (strong Excel skills are preferred).</li>
<li>Candidates who adapt well to priority changes, deadlines, and consistently are quick to respond to and/or acknowledge communications (both from internal &amp; external sources).</li>
<li>Positive and outgoing disposition, eager to work as a team but also functions well working independently.</li></ul> 


WHAT YOU'LL DO:
A detailed list of job duties includes (but is not limited to):
<ul>
<li>Process new bond data and renewals in the surety bond management system (Tinubu)</li>
<li>Accurately process client invoices in accordance with established billing cycles and organizational standards (Sagitta).</li>
<li>Generate statement invoices for applicable clients monthly</li>
<li>Serves as billing liaison between the internal team personnel to provide support and coordination with accounting.</li>
<li>Communicate with the team about operations activities to meet daily deadlines.</li>
<li>Reconcile monthly billing statements to ensure accuracy.</li>
<li>Serve as a point of contact for underwriters to request invoices and renewal documentation, ensuring timely and accurate exchange of information.</li>
<li>Manage accounts receivable aging report and contact clients regarding overdue payments</li></ul> 


WHAT YOU'LL BRING:
Continual Expectations and Requirements of the Position
<ul>
<li>Gain knowledge of the product through daily activities and training</li>
<li>Attend surety training seminars when available</li>
<li>Obtain state notary commission</li>
<li>Obtain state insurance license</li>
</ul>
Education Requirements
<ul>
<li>High School / GED Education required</li>
<li>1-2 years of experience in insurance industry, finance or accounting</li>
<li>Demonstrate strong proficiency in Word and Excel.</li>
</ul>
Skills &amp; Qualifications:
<ul>
<li>Strong verbal and written communication skills.</li>
<li>Articulate, well organized, and focused.</li>
<li>Must be punctual and reliable.</li>
<li>Goal oriented and highly motivated and resourceful to achieve results.</li></ul> 


COMPENSATION:
The base pay offered will be determined based on your experience, skills, training, certifications and education, while also considering internal equity and market data. 


WHY EPIC:
EPIC has over 60 offices and 3,000 employees nationwide &ndash; and we're growing! It's a great time to join the team and be a part of this growth. We offer:
<ul>
<li>Generous Paid Time off
<ul><li>Managed PTO for salaried/exempt employees (personal time off without accruals or caps); 22 PTO days starting out for hourly/non-exempt employees; 12 company-observed paid holidays; 4 early-close days</li>
</ul></li><li>Generous leave time options: Paid parental leave, pregnancy disability and bonding leave, and organ donor/bone marrow donor leave</li>
<li>Generous employee referral bonus program of $1,500 per hired referral</li>
<li>Employee recognition programs for demonstrating EPIC's values plus additional employee recognition awards and programs (and trips!)</li>
<li>Employee Resource Groups: Women's Coalition, EPIC Veterans Group</li>
<li>Professional growth &amp; development: Mentorship Program, Tuition Reimbursement Program, Leadership Development</li>
<li>Unique benefits such as Pet Insurance, Identity Theft &amp; Fraud Protection Coverage, Legal Planning, Family Planning, and Menopause &amp; Midlife Support</li>
<li>Additional benefits include (but are not limited to): 401(k) matching, medical insurance, dental insurance, vision insurance, and wellness &amp; employee assistance programs</li>
<li>50/50 Work Culture: EPIC fosters a 50/50 culture between producers and the rest of the business, supporting collaboration, teamwork, and an inclusive work environment. It takes both production and service to be EPIC!</li>
<li>EPIC Gives Back &ndash; Some of our charitable efforts include Donation Connection, Employee Assistance Fund, and People First Foundation</li>
<li>We're in the top 10 of property/casualty agencies according to &quot;Insurance Journal&quot;</li>
</ul>
To learn more about EPIC, visit our Careers Page: https://www.epicbrokers.com/about/epic-careers/. 


EPIC embraces diversity in all its various forms&mdash;whether it be diversity of thought, background, race, religion, gender, skills or experience. We are committed to fostering a work community where every colleague feels welcomed, valued, respected and heard. It is our belief that diversity drives innovation and that creating an environment where every employee feels included and empowered, helps us to deliver the best outcome to our clients.

California Applicants - View your privacy rights at: https://www.epicbrokers.com/wp-content/uploads/2025/01/epic-ca-employee-privacy-notice.pdf.

Massachusetts G.L.c. 149 section 19B (b) requires the following statement: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability. 


#LI-AT1

#LI-Hybrid

(3207)</div>

Insurance Invoice Analyst

DAMANA

<div>
 
 
 Company Overview
 
 
 
 
 Damana
 
 is a leading player in the insurance industry, committed to delivering innovative, technology-driven solutions to our clients. We are currently seeking a highly skilled
 
 Digital Business Analyst
 
 to join our
 
 Enterprise Architecture Team
 
 and support digital transformation initiatives within the
 
 medical insurance
 
 domain.
 
 
 
 
 
 
 Position Summary
 
 
 
 As a
 
 Digital Business Analyst
 
 specializing in
 
 medical insurance
 
 , you will analyze and optimize business processes related to
 
 medical claims
 
 ,
 
 policy administration
 
 , and
 
 adjudication workflows
 
 . You will support digital initiatives through structured documentation, process mapping (using
 
 Microsoft Visio
 
 ), and technical collaboration. Your role also includes identifying and mitigating
 
 Fraud, Waste, and Abuse (FWA)
 
 , ensuring compliance, and delivering insightful analytics through tools such as
 
 Power BI
 
 .
 
 
 You will work cross-functionally with business, compliance, and technology teams to drive efficient, secure, and compliant operations.
 
 
 
 
 
 
 Key Responsibilities
 
 
 
 
 Requirements Gathering &amp; Analysis
 
 
 <ul>
 <li>
 Collaborate with stakeholders to gather and document business and functional requirements related to medical claims and insurance policies.
 </li>
 <li>
 Translate complex business needs into clear documentation, including user stories and functional specifications.
 </li>
 <li>
 Ensure business rules related to
 
 ICD/CPT coding
 
 ,
 
 claims adjudication
 
 , and
 
 FWA handling
 
 are accurately captured.
 </li>
 </ul>
 
 
 Medical Claims, Adjudication &amp; FWA Analysis
 
 
 <ul>
 <li>
 Analyze end-to-end workflows for
 
 medical claims processing
 
 , adjudication rules, and benefit validation.
 </li>
 <li>
 Support rule configuration and decision logic for claim approvals, denials, co-pays, and benefit limits.
 </li>
 <li>
 Identify patterns of
 
 Fraud, Waste, and Abuse (FWA)
 
 and propose preventive and detection mechanisms.
 </li>
 <li>
 Collaborate with compliance teams to align with medical insurance regulations and audit requirements.
 </li>
 </ul>
 
 
 Business Process Analysis
 
 
 <ul>
 <li>
 Use
 
 Microsoft Visio
 
 to document and maintain detailed process maps and flowcharts.
 </li>
 <li>
 Apply
 
 BPMN standards
 
 to model current (as-is) and future (to-be) processes for claims, policy, and adjudication functions.
 </li>
 <li>
 Propose automation and process optimization opportunities for digital transformation.
 </li>
 </ul>
 
 
 Business Intelligence &amp; Analytics
 
 
 <ul>
 <li>
 Develop dashboards and reports using
 
 Power BI
 
 or other analytical tools to monitor claim trends, exceptions, FWA indicators, and performance KPIs.
 </li>
 <li>
 Analyze structured and semi-structured data to generate actionable business insights.
 </li>
 <li>
 Collaborate with data and actuarial teams to support advanced analytics and forecasting.
 </li>
 </ul>
 
 
 Release Management
 
 
 <ul>
 <li>
 Define deployment plans for changes to claims processing systems, adjudication engines, or policy management platforms.
 </li>
 <li>
 Support testing, UAT, go-live, and post-implementation documentation and training.
 </li>
 <li>
 Ensure change releases are well-governed, traceable, and aligned with business needs.
 </li>
 </ul>
 
 
 Enterprise Architecture Support
 
 
 <ul>
 <li>
 Create and maintain architecture diagrams (applications, databases, integrations) in EA tools.
 </li>
 <li>
 Ensure solutions align with enterprise architecture principles and documentation standards.
 </li>
 <li>
 Maintain updated assets and business process models in the EA repository.
 </li>
 </ul>
 
 
 
 
 
 Qualifications
 
 
 <ul>
 <li>
 Bachelor's degree in
 
 Computer Engineering
 
 ,
 
 Information Systems
 
 , or a related field.
 </li>
 <li>
 Proven experience as a Business Analyst in the
 
 insurance sector
 
 , particularly
 
 medical insurance
 
 .
 </li>
 <li>
 
 Strong domain expertise in:
 
 </li>
 <li>
 
 ICD and CPT coding
 
 </li>
 <li>
 
 Medical claims adjudication
 
 </li>
 <li>
 
 Medical policy structures and benefit rules
 
 </li>
 <li>
 
 Fraud, Waste, and Abuse (FWA)
 
 analysis in healthcare claims
 </li>
 <li>
 Proficiency in:
 </li>
 <li>
 
 Microsoft Visio
 
 for process modeling
 </li>
 <li>
 
 Power BI
 
 or similar BI/reporting platforms
 </li>
 <li>
 
 Java
 
 ,
 
 APIs
 
 ,
 
 Python
 
 ,
 
 MongoDB
 
 , and
 
 SQL
 
 </li>
 <li>
 
 Enterprise Architecture tools
 
 </li>
 <li>
 Excellent documentation, communication, and analytical skills.
 </li>
 <li>
 Ability to work across departments in a fast-paced, compliance-focused environment.
 </li>
 <li>
 Knowledge of
 
 project management
 
 or exposure to
 
 Agile/Scrum
 
 is a plus.
 </li>
 </ul>
</div>

Digital Business Analyst

American Commercial Barge Line

<div>Job Title: Risk Analyst 
Company: American Commercial Barge Line 
Location: To be seated in Vacherie, LA or Jeffersonville, IN 
Job Type: Full-Time; Salary

Summary:
American Commercial Barge Line is seeking a dynamic Risk Analyst to manage Marine Property, Hull, and Cargo claims. This role involves regular interaction with internal units, insurance underwriters, and outside experts like surveyors, salvors, structural engineers, and naval architects. The Risk Analyst will deny, settle, or authorize payments up to a predetermined limit, based on developed facts, appraisals, verifiable damage, and legal standards, for routine to moderate claims. This role offers a unique opportunity to work collaboratively and make impactful decisions in the maritime industry.

When you join ACBL&hellip; 
 
American Commercial Barge Line (ACBL) is one of the largest and most diversified marine transportation companies in the U.S. Our legacy of providing the nation with the most economical, safest, and greenest mode of transportation dates all the way back to 1915, when we began moving coal on the Kentucky River. We offer a wide range of career paths in both operations and support services. Whether you are interested in working on the river or in an office, we are always searching for the best of the best to join our ACBL team.

What you will be doing... Your IMPACT
<ul>
<li>Conduct the investigation, evaluation, negotiation, and settlement of assigned claims advanced against the Company, including:first- and third-party property damage claims, coordinating with outside parties, including customers and experts, and other company departments, as needed; and provide timely reporting to internal management and insurance underwriters.</li>
<li>Coordinate company (lease) and rental vehicle claim management.</li>
<li>Management of USL&amp;H (Longshore) administrative claims with our TPA.</li>
<li>Manage Self-Insured claims by reviewing Team Member&rsquo;s medical history to approve treatment and process payment.</li>
<li>File yearly reports with the Department of Labor and other regulatory organizations.</li>
<li>Assist with the compilation of data for insurance reports and audits.</li>
</ul>
What we are looking for...

You will need to have:
<ul>
<li>High School Dimploma or GED</li>
<li>Valid Driver's License</li>
<li>Proficiency in using MS Office software products and claims database (training to be provided).</li>
<li>Ability to work on-call rotation duties during evening and weekend hours.</li>
<li>Ability to multi-task and excellent written and verbal communication skills.</li>
<li>Possession of organizational skills and results orientation.</li>
<li>Must be dependable in attendance and meet deadlines as established.</li>
<li>Ability to determine priorities and drive decisions with critical thinking.</li>
</ul>
Even better if you have:
<ul>
<li>Bachelor&rsquo;s degree in Business Administration or a related field is preferred.</li>
<li>3-5 Years of previous claims handling experience in a manufacturing or transportation environment is preferred.</li>
<li>Knowledge of inland waterways industry preferred.</li>
</ul>
Reasons you will love working at ACBL ...
<ul>
<li>Competitive salary and benefits package</li>
<li>Opportunities for career growth and professional development</li>
<li>Supportive and collaborative team environment</li>
<li>401(k) retirement plan with employer match</li>
<li>Employee Assistance Program</li>
</ul>
FLSA Status:
Exempt
Equal Opportunity Employer 
This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.</div>

Risk Analyst

Fidelis Resource Management

Key Responsibilities<ul><li>Review and analyze medical records received from insurance companies.</li><li>Allocate cases to field investigators and monitor field investigation progress.</li><li>Prepare trigger points based on case details to guide investigation.</li><li>Draft clear, accurate investigation reports for submission to clients.</li><li>Handle claim closure communication via email and relevant portals.</li><li>Support team leads and contribute to daily operational workflow.</li></ul>Required Qualifications<ul><li>BHMS, BPT, or Post-Graduation in Life Sciences</li></ul>(Biology, Biotechnology, Microbiology, Forensic Science, Pharmacy, Bioinformatics, etc.)<ul><li>Good command of English (verbal &amp; written)</li><li>Proficiency in MS Office (Word, Excel, Email)</li></ul>Job Details<ul><li>Location: Wagle Industrial Area, Thane</li><li>Working Hours: 9:00 AM &ndash; 7:00 PM</li><li>Working Days: 6 Days / Week</li><li>Experience: Freshers accepted</li><li>Salary (In-Hand): &#8377;16,390 per month (CTC: &#8377;20,000)</li><li>Increment: Annual performance-based increment</li></ul>Send your resume to: fidelisrmservices@gmail.com Or call HR directly: 9920525398Job Types: Full-time, Permanent, FresherPay: &#8377;240,000.00 per yearWork Location: In person

Medical Claim Analyst/ Executive

مستشفى دار الشفاء - Dar Alshefa Hospital

<div>
 <ul>
 <li>
 
 JOB SUMMARY
 
 </li>
 </ul>
 
 The insurance doctor is responsible for managing all insurance-related activities for the hospital, ensuring that medical claims are accurate, compliant, and processed efficiently to maximize reimbursement and minimize denials. It is a hybrid role combining deep clinical knowledge, insurance expertise, data analysis, team leadership, and process improvement.
 
 
 
 
 <ul>
 <li>
 
 KEY ACTIVITIES AND RESPONSIBILITIES
 
 </li>
 </ul>
 
 
 
 <ul>
 <li>
 Evaluate and process claims in accordance with insurance policy, terms and conditions, and MNGHA policies and procedures. Review medical reports and ensure proper entry and compatibility with the services provided by the hospital.
 </li>
 <li>
 Check the accuracy of medical information with supporting documents (i.e., laboratory, pharmaceutical, radiology, etc.).
 </li>
 <li>
 Communicate with the treating physician/medical team for any clarification or completion of missing information.
 </li>
 <li>
 Escalate pending cases to the concerned department and follow up directly with Medical Services. Coordinate and follow up with the approving officer(s) on discrepancies in the official form.
 </li>
 <li>
 Collaborate with the claims section team on clinical queries/requests to reassess the claims.
 </li>
 <li>
 Collaborate and communicate with insurance company representatives, such as claims adjusters or medical reviewers, to provide additional information or clarification about the medical services provided.
 </li>
 <li>
 Develop a billing system to improve Revenue Cycle Management (RCM) and decrease the number of rejections. Report any observations related to claims that may affect the RCM.
 </li>
 <li>
 Facilitate the reconciliation process, respond to rejected claims with proper justifications in accordance with the insurance requirements, and coordinate with the insurance companies for resubmission in a timely manner.
 </li>
 <li>
 Participate in establishing, developing, and implementing guidelines to evaluate and process medical claims.
 </li>
 <li>
 Assuring requires preauthorization or prior approval for specific treatments, procedures, or medications.
 </li>
 <li>
 Collect sufficient information for each issue and escalate it to the concerned department.
 </li>
 <li>
 Provide professional advice to subordinates on all aspects of medical insurance practice and law.
 </li>
 <li>
 Assume the responsibilities of Claims Analyst as and if required.
 </li>
 <li>
 Prepare and present necessary reports and correspondences as required by the Executive Management and Senior Executive Management.
 </li>
 <li>
 Perform other job-related duties.
 </li>
 </ul>
 
 
 
 <ul>
 <li>
 
 Key Result Areas
 
 </li>
 </ul>
 
 
 
 <ul>
 <li>
 Weekly/Monthly Claims Processed
 </li>
 <li>
 Coding &amp; Documentation Accuracy
 </li>
 <li>
 Query Resolution Time
 </li>
 <li>
 Reduction in Missing Information
 </li>
 <li>
 Reduction in Claim Rejection/Denial Rate
 </li>
 <li>
 Reduction in Pending Cases
 </li>
 <li>
 Discrepancy Resolution
 </li>
 <li>
 Timely Resubmission
 </li>
 <li>
 Reduction in Write-offs
 </li>
 <li>
 Timeliness and accuracy of financial reports produced
 </li>
 <li>
 Number Reporting breaches identified
 </li>
 <li>
 Consolidations, Reporting &amp; Analysis
 </li>
 </ul>
 
 
 
 <ul>
 <li>
 
 Qualifications
 
 </li>
 </ul>
 
 
 
 
 Degree in Medicine or equivalent
 
 
 
 
 <ul>
 <li>
 
 Technical Skills
 
 </li>
 <li>
 Knowledge of CBAHI, Ministry of Health care policy and procedure.
 </li>
 <li>
 Knowledge of the health care sector.
 </li>
 <li>
 Knowledge of Medical coding, billing process and Clinical Documentation for RCM
 </li>
 <li>
 Clinical Understanding
 </li>
 <li>
 Work-stream leads, subordinates, healthcare team, physicians, insurance companies
 </li>
 <li>
 High paced environment with intense deadlines
 </li>
 <li>
 Great deal of details and accuracy
 </li>
 </ul>
 
 
 
 <ul>
 <li>
 
 Behavioural Skills
 
 </li>
 <li>
 Attention to Detail
 </li>
 <li>
 Professional Communication
 </li>
 <li>
 Analytical Skills: Ability to analyse denial trends and identify root causes
 </li>
 <li>
 Problem-Solving: Proactive in creating solutions to prevent future claim rejections
 </li>
 <li>
 Persistence &amp; Follow-up: Tenacity in managing the appeals and resubmission process.
 </li>
 <li>
 Business Acumen
 </li>
 <li>
 Strategic Thinking
 </li>
 <li>
 Leadership Skills
 </li>
 <li>
 Ethical and Personal Integrity
 </li>
 </ul>
</div>

Insurance Doctor

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