HEALTH INSURANCE ASSISTANT

Description

Job Summary: The professional will analyze, verify, and control the release of billing forms and authorizations from health insurance providers, ensuring process regularization and completion. Key Highlights: 1. Analysis and release of billing forms and authorizations 2. Coordination with departments to resolve process issues 3. Tracking pending items and contacting health insurance providers **Job Description:** * Perform activities related to the Billing Forms Center, analyzing pending cases to identify potential irregularities for billing form release; * Receive and review billing forms to verify completeness and accuracy of information, and assess whether initial authorizations have already been granted according to each insurer's rules, coordinating with responsible departments as needed for resolution; * Verify that the billing forms screen is correctly filled in with authorizations granted by the health insurance provider, and update the billing forms screen with newly granted authorizations as requested; * Digitize and attach authorized documents (billing forms and room sheets) related to the account to be released onto the billing forms screen; * Analyze billing forms to determine whether additional information is required—such as extensions, procedures, chemotherapy, materials, medications, or post-operative medical equipment (OPME)—to ensure full completion for effective release; * Request necessary authorizations; * Track pending authorizations from health insurance providers and contact them via telephone or email, adhering to pre-established deadlines; * Review hospital bills to confirm whether performed services match those requested and whether all are authorized by the health insurance provider; **Requirements:** **Mandatory:** * Completed high school education; * Proficiency in Microsoft Office suite; * Experience in customer service; **Desirable:** * Higher education degree; * Knowledge of coverage rules, health insurance fee schedules for medical procedures; * Understanding of health insurance provider rules; * Experience in customer service within a hospital environment;