Claims Officer at Guru Nanak Ramgarhia Sikh Hospital [Guru Nanak R.S Hospital]

Key Responsibilities:

• Ensure all invoices and claims from Outpatient Clinic and Inpatient Billing Clerks Office are received in Finance Claims Office as per the SOPS
• Ensure all IDS (Internal Dispatch Summary Reports) are acknowledged via signing and a copy sent/scanned and emailed to the billing clerk's office on weekly basis.
• Ensure completeness and accuracy of claims and invoices (signing by the doctor and client, presence of diagnosis, membership/policy number, claims are within the limit) and presence of smart reports where applicable
• Ensure all EDS (External Dispatch Summary Report) are acknowledged/stamped received by respective Insurance/Client contact person and a copy sent back and received by Finance Claims Office daily basis. This stamped external dispatch report must be scanned and save in the claims cloud folder and hard copy filed.
• Maintain details of contact person at each insurance who is responsible for receiving and confirming receipts of invoices and claims dispatched.
• Submitting monthly reports on the status of designated insurance and internal dispatch reports
• Ensure adherence to the laid down SOPs in Claims management
• Ensuring that all the insurance company requirements are met before claims are submitted.
• Participate in preparation or implementation of project of choice within the group operations during the year-MED 360 Ensure claims functions and reports in the system are working properly and continuously.

Qualifications & Experience:

• Degree in Finance or Accounting or ACCA Part 2/CPA K Part/Sec 2 or above
• 2 years accounting experience preferably in hospital setup.

Key Competencies:

• Must have strong work ethics
• Good mathematical background
• Proficient in Excel and Word and experience with automated. accounting systems
• Ability to sort, check, count, and verify numbers Ability to multi-task, prioritize and work efficiently