Patient Services Representative

Ensure accuracy in Pre Authorization and Patient History documentbefore the former is send to TPA.

Communicate to the CC Manager about any possible denials before thepatient is admitted by monitoring the recorded preauthorization or Historysheet.

Proactively follow up on enhancements and ensure that the approval isreceived before the patients time of discharge.

Monitor the outstanding amount for the patient against the approvedpackages and inform CC manager about possible payments which the patient has tomake.

Ensure that the bills are complete and according the package.

Ensure discharges for credit patients are done within 4 hours bycoordinating with the ward managers.

Ensure that the files are sent to Insurance Company as per the definedTAT.

Keep a good relationship with the TPAs and Corporates.

Ensure accuracy of bills sent to corporates and that they are havingthe necessary Codes and rates with all supporting documents, thereby reducingdisallowances.

Keep track of the bills send for payments and ensure that they aresend within 7 days of discharge.

Disclaimer: This job posting and Location has been aggregated from external source. Role details, content, and availability are subject to change. Applicants are advised to confirm the latest information directly on the company website before applying.