ADMINISTRATIVE ASSISTANT

Description

Job Summary: Claims Analyst responsible for performing analysis, verification, and control of medical insurance claim forms and authorizations, interacting with departments and insurance providers to resolve issues. Key Highlights: 1. Analysis and approval of medical insurance claim forms and authorizations. 2. Coordination with insurance providers and internal departments to resolve pending issues. 3. Monitoring and tracking of authorizations. **Job Description:** * Perform tasks related to the Claims Center, analyzing pending cases to identify potential irregularities for claim form approval; * Receive and review claim forms, verifying that they are fully and correctly completed, and assessing whether initial authorizations have already been granted in accordance with each insurer's rules, coordinating with relevant departments as needed for resolution; * Verify that the claim form screen is correctly populated with authorizations granted by the insurance provider, and update the claim form screen with newly granted authorizations according to requests; * Monitor pending returns of insurance authorizations, contacting providers via phone or email while adhering to predefined deadlines; * Review hospital bills to confirm whether performed services were requested and whether all services are authorized by the insurance provider; **Requirements:** **Mandatory:** * Completed High School education; * Proficiency in Microsoft Office suite; * Experience in customer service; **Desirable:** * Higher education degree; * Knowledge of ANS coverage rules and insurance provider fee schedules for medical procedure billing; * Understanding of insurance provider policies; * Experience in customer service within a hospital environment;