About the role
·Ensure accuracy in Pre Authorization and Patient History document before the former is send to TPA.
·Communicate to the CC Manager about any possible denials before the patient is admitted by monitoring the recorded preauthorization or History sheet.
·Proactively follow up on enhancements and ensure that the approval is received before the patient’s time of discharge.
·Monitor the outstanding amount for the patient against the approved packages and inform CC manager about possible payments which the patient has to make.
·Ensure that the bills are complete and according the package.
·Ensure discharges for credit patients are done within 4 hours by coordinating with the ward managers.
·Ensure that the files are sent to Insurance Company as per the defined TAT.
·Keep a good relationship with the TPA’s and Corporates.
·Ensure accuracy of bills sent to corporates and that they are having the necessary Codes and rates with all supporting documents, thereby reducing disallowances.
·Keep track of the bills send for payments and ensure that they are send within 7 days of discharge.