DUTIES & RESPONSIBILITIES

1. Maintains established departmental policies and procedures, objectives, quality assurance program, safety standards and customer care protocols.
2. Answers telephone, routes callers, takes messages and provides routine information to callers.
3. Opens and routes incoming mail; distributes correspondence and other material to department staff
4. Operates office equipment such as fax machines, copiers, and phone systems, and uses computers for spreadsheet, word processing, database management and other applications
5. Typewrites letters, memoranda and reports from written copy, Dictaphone equipment or transcription. Proofs materials for errors and ensures layout is as per the prescribed Hospital standards.
6. Completes forms on behalf of the Medical Director & Assistant Medical Director for his/her review in accordance with company procedures, and makes copies of correspondence/ other printed material.
7. Establishes and maintains files and records on an ongoing basis; maintains paper and electronic filing systems for records, correspondence, and other material.
8. Schedules and coordinates meetings and acts as minute taker for assigned committees; composes, types, and distributes meeting notes, routine correspondence and reports.
9. Maintains complete confidentiality of all sensitive matters relating to the department
10. Participates in educational programs and in-service lectures/workshops
11. Attends meetings as required
12. Performs other related duties as assigned or requested.

KEY CONTACTS

JOB REQUIREMENTS

Primary Responsibilities:

1. Review medical records and associated documentation to ensure they are complete, accurate, and compliant with relevant regulations.
2. The Medical Auditor is responsible for performing detailed audits of medical records and other data to identify errors and inaccuracies, and to assess the accuracy of claims submitted for payment
3. The auditor will also provide guidance and assistance to medical providers on how to improve their documentation and coding practices.
4. The ultimate goal is to ensure that all medical services are properly documented, coded, and billed in order to maximize reimbursement and minimize fraud and abuse
5. Analyze medical data for cost efficiency and appropriateness of care
6. Properly audit all type of claims from the medical and insurance perspective
7. Assure meeting the daily assigned target in terms of quantity & quality
8. Report back any type of claims observation or issues that may affect the process.
9. Participate in developing the billing system by providing new ideas or proposal in order to enhance the process
10. Contribute in developing, updating and implementing the guidelines for evaluation and processing of medical claims, as well as policies and procedures and work instructions related to medical claims review and processing
11. Gather relevant information to clearly describe and properly escalate issues to insurance manager
12. Ensure that business decisions and processes are documented in a professional way and the communication requirements are being adhered to in a timely and professional manner
13. Conduct training to improve the technical, insurance and medical skills and knowledge for team members as assigned by insurance manager
14. Provide all the needed support as advised by insurance manager based on the business need
15. Other related tasks assigned by the line manager

JOB REQUIREMENTS

Operational Duties

2. Develops/reviews comprehensive operational policies for each unit so as to conform to the objectives of the Hospital.
3. Maintains sound Customer Service principles and respond to complaints and concerns of patients, visitors and staff with regard to the support services.
4. Ensures sufficient delivery of services and attention to VIP patients and guests.
5. Conducts orientation /training for new employees to explain policies and work procedures, assigns tasks and closely supervises them until fully trained.
6. Initiates steps to improve the unit functioning. Makes recommendations to improve service and ensure more efficient operations.
7. Maintains interface with departmental personnel to coordinate operational activities to ensure adequate staffing, space and facilities, coordination of purchasing, maintenance and renovation activities for the operational areas.
8. Ensures a safe environment of care for all staff, patients, and families
9. Develops and supports unit shared governance structure. Assures staff participation in developmental activities.
10. Prepares scheduled and periodic reports of facility usage and cleaning conditions.

Supervisory Function

1. Coordinates and directs the activities of Housekeeping services, Laundry & Linen services and Waste Management Disposal services.
2. Overseas Hospital’s support service operations to ensure maintenance of infection control standards, in co-operation with Infection Control unit, in accordance with established policies and practices.
3. Conducts inspection to ensure adequacy of staffs’ activities.
4. Manages the support services staff through direct immediate supervisor and the unit as a whole to ensure cleanliness of the exterior and interior of the Hospital.

General Duties

1. Oversees events held at NMH; interacts with caterers, and/or auxiliary staff as appropriate to the specific event.
2. Enhances professional growth and development through participation in educational programs, current literature, in-service meetings and workshops
3. Coordinates with Facility Management & Safety Committee & Infection Control Committee.
4. Attends meetings as required
5. Performs miscellaneous job-related duties as assigned.

KEY CONTACTS

JOB REQUIREMENTS

DUTIES & RESPONSIBILITIES

General Duties

1. Adheres to established departmental policies & procedures and initiates action, to attend patients, as per established procedures.
2. Greets patients and patient visitors, determines nature/ purpose of visit and directs them accordingly.
3. Answers queries on telephone and makes appointments for the patients, over the telephone if necessary.
4. Provides information about Hospital, such as location of departments/offices, employees within the organization or services provided.
5. Handles patients registration, all clinical booking procedures, schedules appointments and does follow ups.
6. Ascertains from the patient the Physician he/she desires to consult. Enters necessary information in the system and prepares required documents & appointment slips.
7. Guides patients to the proper clinic/patient’s room in coordination with the attending porter.
8. Verifies all insurance benefits assigned to the Hospital to determine whether insurance coverage meets the standards as per the Hospital policy.
9. Verifies fee collected from various patients and hands over the cash to the Reception Supervisor for depositing in the Finance Department.
10. Maintains departmental records and files and takes care of Department equipment.
11. Participates in departmental meetings and related in-service educational programmers.
12. Attends training courses related to new task, if required.
13. Performs other duties as and when assigned
    In Patient Department Duties
14. Prepares pre-admission and admitting forms & reports and facilitates room transfers.
15. Files registration and makes appointments for the patients.
16. Reviews Hospital admissions to ensure accurate financial & biographical data, ensures proper procurement and maintenance of documentation into the Hospital records.
17. Makes bed assignments in collaboration with the Nursing units, based on patient preference, condition and diagnosis.
18. Notifies department head about admissions that do not meet the Hospital financial policy criteria.
19. Reviews and prepares admitting and death or birth records to ensure compliance with medical-legal requirements.

JOB REQUIREMENTS

WORKING CONDITIONS

• Works indoors throughout the shift in temperature controlled, clean, well light and pleasant surroundings.
• May involve long periods of sitting; telephone and in front of a computer screen. Occasionally stands and walks short distances; bend, stoop and reach to perform routine job tasks.
• Requires the ability to work under pressure with a diverse population, including staff, physicians, clients, patients, insurance companies and other members of the public

DUTIES & RESPONSIBILITIES

1. Develops/modifies approved new/current HMIS modules with the aim of solving business problems or automating business processes to improve controls and operational efficiency.
2. Assists in the development of interfaces between HMIS and ERP and provides on-going support.
3. Coordinates with Team Lead and IT manager to resolve issues related to oracle HMIS systems and provides support for HMIS.
4. Analyzes user requests for changes or enhancement to existing software, proposes architecture and design solutions for discussion with Manager-IT
5. Maintains accurate quality control documentation and prepares project progress reports.
6. Attends telephonic inquiries for assistance with the system. Diagnoses and trouble-shoots day-to-day problems faced by end users; analyzes and recommends ‘fixes’ to solve reported problems.
7. Attends to end-users in person, as required, for identification of issues and provides solutions to minor problems in minimum possible time.
8. Makes presentation or demonstrates software solutions to operational users.
9. Provides training to end users in the usage of new, enhanced or modified software/ systems.
10. Interacts with users through various phases of design, development, implementation & maintenance.
11. Maintains daily work progress and time spent on various activities on the assigned project through project charter id.
12. Maintains appropriate Helpdesk records, reports and files on the update and deletion of data.
13. Participates in review and update of Policies and Procedures manuals.
14. Attends departmental and committee meetings as required.
15. Performs such other duties as may be assigned.