SEHA (PureHealth)
The Submission Officer is responsible for managing and monitoring healthcare insurance claims and billing processes to ensure compliance with insurance policies, contractual agreements, and facility pricing guidelines. The position involves validating and processing inpatient and outpatient claims, resolving rejected or unpaid claims, preparing financial documentation and statements, and ensuring accurate insurance-related records. This Officer also provides financial support to patients and clinics, addresses inquiries, identifies and resolves billing issues, and contributes to process improvement initiatives while collaborating with internal teams to enhance operational efficiency and compliance.
Qualification: Bachelor's Degree or Diploma in any related field (medical/health science) Special Certificate: AAPC or AHIMA Certification Required: 2-4 years of relevant progressive experience in a similar role Desired: Experience in a large healthcare facility
Manage and monitor healthcare insurance claims and billing processes to ensure compliance with insurance policies, contractual agreements, and facility pricing guidelines. Validate and process inpatient and outpatient claims, resolve rejected or unpaid claims, and prepare financial documentation and statements. Ensure accurate insurance-related records. Provide financial support to patients and clinics, address inquiries, identify and resolve billing issues, and contribute to process improvement initiatives while collaborating with internal teams to enhance operational efficiency and compliance.