Patient Admin Executive

Role Overview

Patient Admin Executive at NMC Healthcare. The role encompasses front-desk patient services, insurance verification and claims management, and administrative support across the medical facility.

Role Purpose

Deliver comprehensive administrative and patient-facing services including patient greeting and registration, insurance verification and claims processing, email management, and operational support to ensure smooth facility operations and compliance with hospital policies and quality standards.

Key Responsibilities

Patient Services & Reception

• Greet patients upon arrival and direct them to appropriate departments.
• Provide routine information about the hospital when necessary.
• Maintain a safe and clean reception area in compliance with procedures, rules, and regulations.
• Exercise effective interpersonal skills in dealings with department staff, colleagues, and management.

Registration & Data Management

• Confirm and register new patients.
• Enter new patient information and update in the system.
• Maintain accurate records of all patient information.
• Maintain high standards of data accuracy while ensuring compliance with privacy regulations.
• Maintain patient and staff confidentiality.

Insurance Verification & Claims

• Verify patients' insurance coverage and eligibility.
• Maintain updated records of insurance policies, benefits, and limits.
• Educate patients about their insurance coverage and co-payments.
• Handle patient queries regarding claims, approvals, or reimbursement.
• Maintain accurate records of all insurance claims and payments.
• Keep the pending approval monitoring system updated for next-day follow-up.
• Ensure correct documentation is attached for claims.
• Resolve discrepancies and billing discrepancies related to insurance.
• Guide staff to follow correct ICD and CDT codes to avoid rejection.
• Coordinate with head office insurance team for escalations when required.
• Keep all insurance records updated and ready for audits and inspections.
• Stay updated on insurance policies, regulations, and guidelines.

Communications & Coordination

• Check emails daily and respond to queries in a timely manner.
• Work closely with the front desk, billing team, and clinical staff to ensure accurate documentation and billing.

Compliance & Quality

• Ensure operations are carried out uniformly according to hospital policies and procedures.
• Strictly adhere to NMC's regulations and policies, especially those related to infection control, patient safety, and JCI.
• Ensure complaints are handled in a structured, timely, and professional manner that is fair, courteous, and respectful of privacy.
• Support Continuous Quality Improvement and participate in all quality assurance activities of the service.
• Ensure compliance with insurance rules and clinic policies.
• Participate in hospital training programs.
• Follow the duty schedule as assigned by the team leader or supervisor, including different shift timings as per departmental need.
• Accomplish related results as needed and contribute to team effort.

Qualifications & Experience

• College Diploma in any discipline or related fields.

Additional Information

• Shift work required; different shift timings as per departmental need.