Medical Insurance:

• Responsible for the accurate flow of medical information and patient data between physicians, patients and third-party payers with the use of accurate code to define diagnostics, treatments and procedures and to enter this information into a the facility’s database using medical coding protocol to produce a statement or claim.

• To act as a liaison between the facility and payment parties to investigate the claim, verify its information, and update the database in the instance that a claim is denied by the third-party payer.

• Review patient medical records

• Communicating with medical billing specialists to ensure treatment codes are accurately received

• Submission of claims

• Taking timely approval of investigations/ procedures.

Medical Invoicing:

• Invoicing the services as per the agreed prices.

• Receiving patient treatment codes to use in assembling reimbursement claims

• Make sure CPT codes are accurate as per service

• Billing patients for medical services

• Enter patient information into computer files, and possibly also in paper records

• Organize, manage, and sort paperwork (including patients’ charts)

• Continue to enter data as patients are subjected to diagnostic tests and receive treatments

• Prepare and mail billing statements

• Resolve conflicts regarding payments and reimbursements

• Investigate and report instances of insurance fraud

• Provide information and prepare documents for legal inquiries and litigation

• Ensure the confidentiality of patients’ personal information

• Perform clerical duties that may include answering the telephone, greeting patients, and sorting mail

Customer Service:

• Provides a high level of customer service to the patients.

• Interacts with client with professional and personal manner.

• Responds to questions according to regulatory protocols.

• Guides flow of clinic traffic and directs clients to open station.

• Maintains client schedule at clinics that have pre-scheduled appointment times.

• Assists in accurate and legible documentation of clinic forms.

• Assures every client is signed in and has completed clinic paperwork.

• Check consent/ insurance form for completeness and legibility before the client goes to the Registered Nurse for services.

• Communicates effectively with client regarding the information that is needed.

• Responds to urgent customer needs in a timely and professional manner.

• Makes recommendations and implements process improvements.

• Participates in fostering a safe workplace.

• Participates in employee job safety analysis to eliminate hazards and prevent accidents.

Cash Handling:

• Manage up-to-date clinic income records by sending and receiving bank checks and documenting all relevant transactions.

• Receives and reconciles cash, checks or credit card for payment and issues receipts as required

• Handles cash box as needed. • Accurately makes change when needed. • Responsible for cash box during clinic and transfers money to accounts department at end of clinic for deposit

• Handle all payments to clinic suppliers and accurately enter daily payment activities (credit, insurance, cash, check, payment for previous visit) into software management system

• Counts and reconciles money in cash drawers at the beginning and end of shifts to ensure that amounts are correct and notifies supervisor if any discrepancy is found

• Transfer income activities to the financial system on a daily basis

• Create daily, weekly, and monthly reports from clinic financial data

• Obtains valid authorization for all credit card payments

• In the event a refund is being requested, initiates checking the system for delinquent accounts or outstanding balance, suggests to apply payment of refund against outstanding balances before processing any refunds

• If a refund is necessary, ensures all appropriate documents and signatures are obtained, and refunds are entered in the system

• Maintains general knowledge of cash handling and controls and complies to cash handling policies and procedures

• Calculates total amounts received and reconciles with supervisor at the end of each shift before closing cash drawers

• Liaise and support other members of the multi-disciplinary team and other agencies relating to patient care, maintaining good communication channels.

• Be aware of safe guarding policies, both local and national, and implement such policies should it become necessary.  

Desired Candidate Profile

• Minimum 2 experience in a similar role.

• Graduate Degree in any stream.

• Experience in all or any area of Insurance, Cash Handling, Customer Service & Invoicing.

• Fluency in English (speak, read and write).

• Arabic speaking skills will be an added advantage.

• Excellent Computer Literacy skills is required.