Senior Resubmission Officer

To ensure that denied, rejected, or underpaid insurance claims are corrected and resubmitted accurately and promptly to maximize reimbursement for healthcare services

The post holder will:

• Analyze the rejections

  
  

• Clarifying the Rejection queries to the Insurance Company

  
  

• Doing Resubmission production for assigned facility with quality.

  
  

• Sharing rejection feedback to the Submission team

  
  

• Sharing rejection feedback to the Approval team

  
  

• Sharing rejection feedback to the reception team.

  
  

• Facilities doubt clearing (Coding, insurance Queries)

  
  

• Monthly team meeting in sharing the ideas regarding insurance rejection.

  
  

• Sharing rejection updates to medical auditor to share with respective doctor.

  
  

• Supporting submission team for their queries

  
  

• Providing justification for reconciliation claims.

  
  

• College Diploma - Any discipline or related fields. 

  
  

• Coding Certification, CPC – Certified Professional Coder (AAPC)

  
  

Proficiency in:

• ICD-10-CM (diagnosis codes)

  
  

• CPT (procedure codes)

  
  

HCPCS Level II (supplies, equipment, services)