Insurance Compliance Officer

Job Purpose / Objective : Responsible for timely and accurate processing of insurance policies. Ensures prompt resolution of patients and accounts creation and activation Key Responsibilities / Accountabilities : - Prepare and distribute Ready Reference Table for all companies (Regular and Insurance) policies. - Prepare and process all companies (Regular and Insurance) policies for entering in the system after obtaining required administrative and management approvals. - Process and enter all companies (Regular and Insurance) policies and information in to S.D Pharmacy system. - Provide information and update Patient Services and Nursing Department about summary of all new, updated, and/or modified company and insurance company information after entering in the system. - Receive and process modifications, renewals, and cancellation for all companies (Regular and Insurance) for updating in the system. - Review and ensure the correctness and accuracy of all companies (Regular and Insurance) data while entering in the system or already entered in the system. - Identify companies and insurance companies with exceptional conditions for review of contracts for renewal. - Oversee the current status of patient accounts and assist in identifying and resolving billing and processing problems. - Analyse billing processes and recommend methods for improvement. - Prepare audits on problem accounts. - Notify and train staff of significant changes. - Advise Director of Business Services of problems and concerns in the department. - Supervise assigned personnel. Assist in training, orientation, and performance evaluation. - Participate in, and lead person-centered care initiatives undertaken by HMG. - Enrich patient experience with compassion, respect and dignity. - Performs other applicable tasks assigned within the level of his/her competence as required Requirements: Education/ Professional Qualification: - Bachelor’s Degree - Business Administration, Accounting or Any related field Experience: - Minimum of five (5) years of experience in claims processing in a health care setting. - Minimum of three (3) years medical office experience in billing, accounting or information systems. - Minimum of two (2) years supervisory or management experience. Professional Licensing / Certification / Training: - N/A