Submission & Resubmission Officer

The Resubmission Officer will be responsible for filing and tracking insurance claims, process insurance and disability claims in a timely manner.

• Process the resubmission of rejected claims on the system, follow up with respective doctors for justification if necessary, and prepare them for resubmission.

• Ensure that the agreed price list and provider manual from insurance companies are followed for billing the service to the respective payers.

• Ensure that all concerned teams, such as FO, coders, and doctors, are updated on time with the rejections and corrective action is taken to avoid such instances in the future.

• 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 & Compliance Responsibilities:

• Comply with all OSH and infection control policies, standards, and procedures and cooperate with hospital management to comply with those requirements.

• Work in accordance with the documented OSH procedures and instructions, specific responsibilities.

• Be familiar with emergency and evacuation procedures.

• Notify OSH hazards, incidents, near misses, and issues, and assist with the preparation of risk assessments and incident reports.

• Comply with waste management procedures and policies.

• Attend applicable OSH/Infection control training programs, mock drills, and awareness programs.

• Use appropriate personal protective equipment and safety systems.

• Ensure that employees follow applicable OSH/Infection control policies, procedures, and standards.

• Provide OSH information, training, and supervision to staff.

• Report any OSH-relevant incidents, near misses, and hazards in the departments in a timely manner.

• Make sure that incident corrective actions have been implemented.

• Assist with preparation of risk assessments and monitoring the control measures.

• Ensure training is conducted, including general/departmental/FMS/OSH orientation for new employees and transferred employees, as well as refresher training for department staff.

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

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

• Experience in Medical Coding is preferable.

• Excellent command of oral and written English.