Senior/ Patient Relations Associater
3 days ago
**Objective / Purpose of the Job**
Senior/ Patient Relations Associate (Claims) is to ensure accurate and timely submission of clinic claims and reconciliation of payment from the insurance company. To provide administrative and billing support to the patient, facilitate the smooth running of the clinic environment, and support the delivery of quality patient care.
As a Senior/ Patient Relations Associate, you will assist the Administrative Director in any patient claims inquiries, feedback management, and implementation of patient relations initiatives.
**Responsibilities**:
**Claims Submission**
- Managing patient’s insurance claims [e.g. enquiries, documentation, verifying patient’s eligibility and coverage for procedures/ treatments, obtaining pre-authorizations and letter of guarantee (LOG).
- Ensuring the completeness of bills and relevant insurance forms and supporting documents for local and global insurance.
- Preparing, reviewing, and transmitting claims using the claim portal, including electronic and paper claim processing.
**Claims Management & Accounts Receivables**
- Following up with insurance companies on unpaid claims, discrepancies in payment, appeals, and resubmissions (where needed)
- Following up with patients to facilitate billing, co-payment & deductibles, and closure of claims, and maintaining an effective recording system.
- Reconciling all payments and transactions for the day.
- Handling patient feedback: including escalation where needed
- Processing offline payment and communications with patients/ payees for payment
- Ad-hoc duties as assigned.
**Patient Relations Associate (Senior) - in addition to above**
- Managing the relationship with various insurance companies and representatives.
- Supporting and guiding team members in managing further enquiries for any claims and settlements efficiently.
- Managing patient feedback and all related claim matters, including:
- Reviewing feedback, establishing root causes, and suggestions to mitigate /resolve.
- Recovering claims with the Insurers and Mediclaims.
- Working closely with clinical team members to follow up to address feedback and issues, crafting replies and related data entry for reporting.
- Preparation of reports and analysis, sharing relevant information with the management when required.
- Supporting, educating, and guiding clinical team members to promote a culture of continuous sharing and learning; claims improvement, identifying service touch points and experience.
**Skills and Abilities**
- Diploma or Degree holders with at least two years’ experience in the healthcare, insurance, or hospitality industry.
- Proven experience as a Claim Specialist or similar role handling insurance or medical claims/ case assessment.
- Pleasant and confident disposition and excellent customer service orientation.
- Exceptional written and oral communication skills.
- Meticulous with the ability to multitask and stay organized.
- Ability to independently follow clinic procedures and job instructions and use good judgment in determining when assistance is needed.
- Computer literacy and good analytical skills.
- High empathy with a passion for patient care
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