Insurance Coordinator GluCare

Key Responsibilities:

• Pre-Approval Coordination: Ensure all required pre-approvals for treatments and procedures are obtained from insurance providers in a timely manner.
• Claims Submission: Prepare and submit insurance claims in compliance with payer policies and regulations, ensuring accuracy and completeness.
• Resubmissions & Appeals: Handle rejected or denied claims by identifying errors or missing information and resubmitting or appealing claims as necessary.
• Invoicing: Generate accurate invoices for patients and insurance companies, ensuring alignment with policy coverage and patient treatment plans.
• Verification of Insurance Coverage: Check and verify patient insurance coverage and eligibility before services are provided, ensuring that the required services are covered under the patient's policy.
• Reconciliation of Accounts: Work with the finance department to reconcile patient accounts, ensure payments are posted correctly, and identify any outstanding balances.
• Patient Support: Provide clear communication and support to patients regarding insurance coverage, claims status, and any financial obligations they may have.
• Maintaining Records: Keep detailed and organized records of all insurance-related documents, claims submissions, payments, and correspondence.
• Liaison with Insurance Providers: Maintain strong working relationships with insurance companies, ensuring quick resolution of issues related to claims or approvals.
• Compliance: Ensure that all insurance activities are in compliance with DHA (Dubai Health Authority) regulations and other relevant healthcare insurance standards in the UAE.
• Regular Reporting: Provide regular reports on claim submissions, approvals, denials, and reimbursements to management for review and action.