Claim Officer

Responsibilities

Oversee Daily Operations: Manage the day-to-day operations of the medical billing team, ensuring smooth workflow and adherence to deadlines.

Performance Evaluation: Conduct regular performance reviews, provide feedback, and set performance goals to improve team productivity and accuracy.

Regulatory Compliance: Stay updated on changes in medical coding and billing regulations, ensuring compliance with CHI and other relevant regulations.

Workload Allocation: Assign tasks and responsibilities to team members based on their skills and workload capacity, ensuring efficient utilization of resources.

Conflict Resolution: Resolve conflicts and issues within the team, promoting a positive and collaborative work environment.

Claim Review: Review and audit claims for accuracy and completeness, identifying and correcting errors to minimize denials.

Quality Assurance: Implement quality control measures to ensure accuracy and efficiency in billing processes.

Interdepartmental Collaboration: Work closely with other departments, such as medical coding, preauthorization, re-submission and denial management, to ensure seamless communication and coordination.

Reporting to Billing Director: Provide regular updates to the Billing Director on team performance, revenue metrics, and operational issues.