Health Insurance Billing Executive at Lagos Executive Cardiovascular Centre

Job Overview:

The Health Insurance Billing Manager will oversee the billing operations related to health insurance claims and patient insurance reimbursements. This role is crucial for ensuring accurate, timely, and efficient processing of health insurance claims and managing relationships with health insurance companies (HMOs) to optimize revenue collection. The ideal candidate will have a strong understanding of healthcare billing practices, insurance reimbursement policies, and excellent leadership skills.

Key Responsibilities:

Insurance Billing & Claims Management:

• Oversee the entire billing process for health insurance claims, ensuring accurate and timely submission to insurance providers (HMOs).
• Ensure proper documentation for insurance claims, including medical coding, billing codes, and patient information.
• Resolve any discrepancies or issues with rejected claims, working closely with insurance companies and healthcare providers to ensure timely reimbursement.
• Manage the submission of claims for both inpatient and outpatient services, ensuring that all charges are appropriately captured and billed.

Team Management:

• Lead and supervise the billing team, providing guidance, training, and support to ensure high performance.
• Assign billing tasks and monitor the completion of billing cycles in a timely and accurate manner.
• Conduct regular team meetings to address challenges, provide updates on policy changes, and ensure continuous improvement in billing processes.

Compliance & Documentation:

• Ensure compliance with all relevant healthcare billing regulations, including those set by insurance providers, regulatory bodies, and internal policies.
• Maintain accurate records of all billing transactions, claims, and payments.
• Stay updated on changes in healthcare insurance policies, reimbursement structures, and coding systems (ICD-10, CPT).

Revenue Cycle Management:

• Collaborate with the finance department to monitor and improve the revenue cycle, identifying opportunities to increase revenue collection and reduce claim denials.
• Develop and implement billing strategies to improve the efficiency and accuracy of the billing process, ensuring optimal reimbursement for services provided.

Customer Service & Dispute Resolution:

• Handle inquiries from insurance companies, patients, and other stakeholders regarding billing issues, claims status, and payments.
• Work closely with the patient services department to resolve any billing-related concerns, ensuring a positive patient experience.
• Resolve billing disputes and follow up on unpaid claims to ensure timely and accurate payments.

Qualifications:

• Bachelor’s degree in Health Administration, Finance, Business, or related field (Master’s degree preferred).
• Minimum of 2 years of experience in healthcare billing and insurance claims management, with at least 2 years in a managerial position.
• Strong knowledge of health insurance billing practices, medical coding (ICD-10, CPT), and insurance reimbursement policies.
• Proven leadership skills, with experience managing a team and driving performance.
• Excellent organizational skills and the ability to manage multiple tasks in a fast-paced environment.
• Attention to detail with strong analytical skills to assess billing data and resolve discrepancies.
• Proficiency in medical billing software and Microsoft Office Suite (Excel, Word).
• Strong communication skills, both written and verbal, with the ability to interact effectively with insurance providers, healthcare teams, and patients.
• Knowledge of Nigerian healthcare insurance providers (HMOs) is an advantage.