Submission & Resubmission Officer

Accurately uploading and verifying claims documentation, coordinating with medical coders to resolve discrepancies, generating status reports, and ensuring timely escalation of issues

Responsibilities

Upload claims documents and data into the claims management system accurately and promptly.

Verify accuracy of claim forms and related documentation before uploading such as checking the card number with given formula, verifying the TPA / Policy is entered correctly and if any Dummy approval was entered.

Coordinate with Medical Coders to resolve discrepancies or missing information.

Assist in generating reports related to claims status and data uploads.

Identify and escalate issues related to claims documentation or data entry to the supervisor.

Perform other administrative duties related to claims processing as assigned.

Qualifications

Bachelors or Diploma - Any Medical discipline or related fields.

with CPC/ AAPC coding certificate