Insurance Coordinator

ESP Engineered; Bahrain; On-site; BHD 15,000 - 25,000; Full time

Job summary

ESP Engineered in Bahrain is looking for a professional skilled in insurance verification and pre-authorization processes. The responsibilities include verifying patient insurance coverage, coordinating prior authorizations with healthcare providers, and managing claim submissions and denials. Candidates should possess strong communication skills and experience in navigating insurance benefits. This role offers the opportunity to work closely with both patients and clinical staff to ensure seamless operations in a healthcare setting.

Qualifications

• Experience with insurance verification processes.
• Strong communication skills for patient interaction.
• Ability to work collaboratively with healthcare providers.

Responsibilities

• Verify patient insurance coverage and benefits.
• Coordinate with physicians for prior authorization.
• Explain insurance benefits and implications to patients.
• Review and submit insurance claims.
• Investigate denied claims and resubmit appeals.
• Monitor accounts receivable for financial health.
• Assist patients with payment plans.
• Collaborate with clinical staff for documentation.
• Resolve disputes between patients and insurance companies.

Job description

1. Insurance Verification & Pre-Authorization

• Eligibility Checks: Verify patient insurance coverage, benefits, and co-pay requirements before appointments.
• Prior Authorization: Coordinate with physicians and insurance companies to obtain approvals for surgeries, diagnostic tests, and specialist referrals.
• Policy Interpretation: Explain complex insurance benefits, deductibles, and "out-of-network" implications to patients in plain language.
• Claim Submission: Review and submit claims
• Denial Management: Investigate rejected or denied claims, correct coding errors, and resubmit appeals to secure payment.
• Revenue Tracking: Monitor "Days in Accounts Receivable" (AR) to ensure the clinic maintains healthy cash flow.
• Financial Counseling: Assist patients in setting up payment plans for balances not covered by insurance.
• Clinical Collaboration: Work with doctors and nurses to ensure documentation supports the medical necessity required by insurers.
• Conflict Resolution: Act as a mediator when disputes arise between the insurance company and the patient regarding coverage.