Job Summary:
The ideal candidate will be a qualified medical doctor with 3-5 years of experience in the insurance industry and/or hospital setting. This role requires a deep understanding of ICD and CPT coding, medical billing guidelines, and proficiency in managing insurance claims.
The Assistant Insurance Manager will play a key role in ensuring accurate and efficient processing of insurance claims, while also supporting the insurance department in various administrative tasks.
Key Responsibilities:
- Oversee and manage the day-to-day operations of the insurance department including the submission, resubmission, and follow-up of insurance claims.
- Ensure accurate coding of medical services using ICD and CPT codes in compliance with current medical billing guidelines.
- Collaborate with medical staff, finance, and IT teams to resolve discrepancies and optimize the billing process.
- Conduct audits of medical claims to identify and correct errors, ensuring compliance with insurance policies and regulations.
- Develop and maintain detailed reports using Excel to monitor claim status reimbursement trends, and department performance.
- Create and deliver presentations using PowerPoint to communicate key insights andupdates to senior management.
- Assist in the training and development of insurance department staff on billing procedures and guidelines.
- Stay updated with changes in insurance policies, medical coding standards, and billing regulations to ensure compliance.
