EntryFull TimeENMiddle East
The Medical Biller is responsible for preparing claims for submission to the National Health Insurance Company as well as other private payers. The incumbent is responsible for timely submission of claims based on agreed submission terms with the insurance providers. He/ She is also responsible for following up on claims and processing resubmissions as required.
KEY ROLE ACCOUNTABILITIES
Releases completed claims for submission.
Requests additional information from clinical areas in response to claims denials or inquiries by insurance providers.
Prepares and processes claims based on claims work lists for submission to insurance providers or TPAs.
Verifies claims for accuracy and completeness of information.
Communicates with clinical areas to resolve any claim edits issues.
Ensures that claim formats concur with insurance provider requirements.
Prepares clean claims for electronic and/or manual submission.
Accesses Cerner Charge Services to produce and submit claims.
Follows up on submitted claims to ensure timely payment processing.
Contacts insurance providers or TPAs on as needed basis.
Identifies unpaid and partially paid claims and takes the necessary steps for appeal or resubmission.
Processes claim re-submission as required.
Posts insurance payments on the system.
Refers patient related liabilities to the AR Section for processing.
Escalates unresolved claims related issues to the Supervisor - Patient Billing and Revenue Reconciliation for further action.
Documents events and interactions using electronic and manual systems.
Maintains billing records in accordance with internal standards.
Adheres to Sidra’s standards as they appear in the Code of Conduct and Conflict of Interest policies
Adheres to and promotes Sidra’s Values
ESSENTIAL
PREFERRED
Education
Bachelor Degree - Commerce, Health Information, or relevant discipline
Experience
2+ years’ of experience in medical billing using an electronic billing and insurance system
Hospital Experience
Experience using Cerner Health Information System