Claims Submission and Data Reporting Officer
- Clin Biosciences
- 15 Positions
- Delhi, NCR
- 2 days ago
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Job Description
- Claims Submission:
- Review, prepare, and submit insurance or healthcare claims to various providers and organizations.
- Ensure claims are submitted accurately and within designated timelines.
- Identify and resolve any discrepancies or errors in submitted claims.
- Work closely with internal teams (e.g., billing, customer service) to obtain any missing information and ensure claim accuracy.
- Maintain a tracking system to monitor the status of submitted claims and follow up as necessary.
- Data Reporting:
- Compile, analyze, and generate regular reports on claims data, including submission statuses, payment details, denials, and adjustments.
- Prepare monthly, quarterly, and annual reports for internal stakeholders or external regulatory bodies.
- Ensure reports meet the required standards for accuracy, compliance, and timeliness.
- Conduct trend analysis to identify opportunities for process improvements and cost savings.
- Compliance and Documentation:
- Stay updated on relevant regulations, industry standards, and best practices related to claims submission and reporting.
- Ensure all claims and data reporting activities comply with company policies and regulatory requirements.
- Maintain thorough documentation of claims processes, outcomes, and communications for audit purposes.
- Collaboration & Communication:
- Communicate effectively with clients, insurance providers, or other third-party organizations to resolve issues related to claims submissions and payments.
- Coordinate with internal teams, including finance, customer service, and operations, to streamline claims processes.
- Provide insights to management and other stakeholders regarding claims trends, potential issues, and recommended solutions.
- Process Improvement:
- Identify inefficiencies or challenges in the claims submission and reporting process.
- Work with the team to develop and implement solutions to improve accuracy, speed, and efficiency.
- Recommend updates to systems or software to streamline data collection, claims tracking, and reporting.
You will play crucial roles in processing insurance claims efficiently and accurately. Their responsibilities include claim creation, verification, submission, tracking, and data analysis, all while adhering to compliance standards and ensuring data accuracy.
Key Responsibilities:
Qualification
Education - Bachelors Degree Required
relevant certifications is also preferred
Experience
Experience with healthcare reporting and data validation.
Proficiency in Microsoft Excel, including the ability to create and manage spreadsheets, use formulas, pivot tables, and generate reports.
Familiarity with medical coding (ICD & CPT), claim submission processes, and healthcare insurance regulations (HAAD/DOH).
Strong attention to detail, analytical skills, and ability to work collaboratively with cross-functional teams.
Strong proficiency in Microsoft Excel, including advanced functions such as VLOOKUP, pivot tables, and data analysis tools.
Strong organizational and time management skills.
Interested to apply can share CV or call/WhatsApp to hidden_mobile
Employement Category:
Employement Type: Full timeIndustry: Pharma / BiotechRole Category: Bio Tech / R&D / ScientistFunctional Area: Not SpecifiedRole/Responsibilies: Claims Submission and Data Reporting OfficerContact Details:
Company: Clin BiosciencesLocation(s): Delhi, NCR
Keyskills: medical claims data reporting healthcare
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