#Qualifications and Experience
• Essential: Medical degree.
• Essential: 3-5 Yrs. experience in claims management.
• Good knowledge of Insurance Regulations, Rules, polices and market trends
• Good experience about denial management and denial trends both technical and medical.
• Good experience in coding processes and standards, (ICD10-CPT-ACHI-DRG).
• Desirable: Fair knowledge of Hospital administration, HIS.
• Team leadership.
• Attention to details.
• Excellent Communication skills.
• Time-management and Conflicts management.
• Ability to work under pressure, in a team.
Leads a team of claims officers and medical auditors upon best practice modules to achieve highest first claim submission to payors and achieve minimum denial rates.
Cooperates with various departments involved at any percentage with claim preparation process (Patient Access, Medical teams, Approval team).