Maintain daily reconciliation processes and all action needed at hospital and client level
Reconciliation meetings with clients to discuss and finalize account rejections
Adhering to resubmission documentation during usual reconciliation process
Preparing resubmission reports to ensure accurate rejection recovery.
Preparing for regularly reconciliation committee meetings to enhance the hospital reconciliation progress
Implementing cross audit with claim audit team to ensure accurate rejection analysis.
Works to prepare processes and dashboards to ensure quality and accuracy.
Undergoing action plans to mitigate rejection reasons.
Contract and discount setup review Reconciliation weekly reports
Stays up to date on medical updates and implements changes regarding claims and billing requirements according to customer needs to enhance digitalization internally and on customer side.
Perform other duties related to RCM as assigned
Bachelor's degree of any medical field (Medicine, Pharmacy or Dentistry).
3 years of working experience in claims operations/healthcare
Significant knowledge of claims management, reconciliation and rejections management and its financial implications.
Ability to establish a high-performance management culture
Excellent interpersonal, communication and influencing skills are required with emphasis on achieving results and successful outcomes.
