Overview

The Submission Officer is responsible for managing and monitoring healthcare insurance claims and billing processes to ensure compliance with insurance policies, contractual agreements, and facility pricing guidelines. The position involves validating and processing inpatient and outpatient claims, resolving rejected or unpaid claims, preparing financial documentation and statements, and ensuring accurate insurance-related records. This Officer also provides financial support to patients and clinics, addresses inquiries, identifies and resolves billing issues, and contributes to process improvement initiatives while collaborating with internal teams to enhance operational efficiency and compliance.

Responsibilities

• Monitor compliance with the insurance company terms and contractual agreements and applicable rules.
• Ensure compliance with the facility pricing structure and the rules for different patient categories (including self-pay...