Senior Officer, Insurance Services

Overview

We are seeking a detail-oriented and proactive Senior Officer, Insurance Services to join our team. In this role, you will play a vital part in supporting both the Finance and Insurance departments by managing day-to-day insurance activities. This includes handling authorizations, claim submissions and resubmissions, and ensuring accurate processing of medical claims.

You will be responsible for ensuring all insurance-related tasks are conducted in compliance with MH’s insurance policies and procedures, contributing to efficient operations and supporting seamless patient care. Your expertise will help maintain the accuracy, integrity, and timeliness of our insurance service delivery.

Responsibilities

• Ensure high accuracy in claims processing for insurance and corporate reviews, in line with contractual agreements, to support timely and efficient reimbursement.
• Coordinate with insurance providers and corporate payers for eligibility verification, pre-authorizations, approvals, and reconciliation of claims and payments.
• Liaise with internal staff to ensure timely and accurate entry of insurance information, while providing frontline support for insurance verification and customer service inquiries.
• Verify claims for compliance with medical billing guidelines and regulatory standards, ensuring consistency and audit readiness.
• Collaborate with physicians and internal stakeholders to communicate updates on insurance protocols and billing practices, and provide relevant training to frontline staff.
• Track receivables and conduct financial reconciliations based on remittance advices, addressing variances and supporting resolution of outstanding balances.
• Maintain comprehensive records and correspondence related to insurance claims, private payers, and corporate accounts.
• Assist in onboarding and training new team members, offering guidance and support in alignment with insurance procedures and organizational practices.
• Support management during internal and external audits by preparing and providing required documentation and insights.
• Develop and analyze insurance claim reports, identify trends in adjustments, bad debts, and contractual allowances, and contribute to ongoing enhancement of insurance processes and policies.
  
  

Qualifications

• Bachelors degree in relevant field.
• Minimum experience of 3 years as coder.
• IVF experience is highly preferred.