Patient Admin Executive

Role Overview

Patient Admin Executive at NMC Healthcare. The role is based at a medical facility and combines front-desk reception duties, patient registration, and insurance administration.

Role Purpose

Deliver efficient patient registration, administrative support, and insurance processing while maintaining compliance with hospital policies, safety standards, and quality improvement initiatives.

Key Responsibilities

Patient Reception & Registration

• Greet patients upon arrival, direct them to appropriate departments, and provide routine information about the hospital.
• Confirm and register new patients.
• Enter new patient information and update records in the system.
• Maintain accurate records of all patient data.

Insurance & Billing Administration

• Verify patients' insurance coverage and eligibility.
• Maintain updated records of insurance policies, benefits, and limits.
• Keep the pending approval monitoring system updated for next-day follow-up.
• Ensure correct documentation is attached for claims.
• Resolve discrepancies in billing and insurance records.
• 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.
• Guide staff to follow correct ICD and CDT codes to avoid claim 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.
• Answer calls on a regular basis.
• Work closely with the front desk, billing team, and clinical staff to ensure accurate documentation and billing.
• Assist in resolving billing discrepancies related to insurance.

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.
• Maintain patient and staff confidentiality.
• Maintain high standards of data accuracy while ensuring compliance with privacy regulations.
• Ensure compliance with insurance rules and clinic policies.
• Support Continuous Quality Improvement and participate in all quality assurance activities of the service.

Complaints & Service Improvement

• Ensure complaints are handled in a structured, timely, and professional manner that is fair, courteous, and respectful of privacy.
• Identify problems and contribute to continuous improvement of the department's services.

Facility & Team Management

• Maintain a safe and clean reception area by complying with procedures, rules, and regulations.
• Contribute to team effort by accomplishing related results as needed.
• Exercise effective interpersonal skills in dealings with department staff, colleagues, and management.
• Participate in hospital training programs.
• Follow the duty schedule as assigned by the team leader or supervisor, which includes different shift timings as per department need.

Qualifications & Experience

• College Diploma in any discipline or related field.