Patient Admin Executive

Role Overview

Patient Admin Executive at NMC Healthcare. This role is based at a medical facility and encompasses patient reception, administrative support, and insurance management duties.

Role Purpose

Deliver comprehensive administrative and patient-facing support to ensure smooth facility operations, accurate patient registration, timely insurance processing, and compliance with hospital policies and quality standards.

Key Responsibilities

Patient Reception & Customer Service

• 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.

Communications & Administrative Operations

• Check emails daily and respond to queries in a timely manner.
• Answer calls on a regular basis.
• Ensure operations are carried out uniformly according to hospital policies and procedures.
• Maintain patient and staff confidentiality.
• Maintain high standards of data accuracy while ensuring compliance with privacy regulations.

Insurance Management & Claims Processing

• 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-ups.
• Ensure correct documentation is attached for claims.
• Resolve discrepancies in claims and billing.
• 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.
• 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.
• Stay updated on insurance policies, regulations, and guidelines.
• Ensure compliance with insurance rules and clinic policies.
• 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.

Patient Registration & Data Management

• Confirm and register new patients.
• Enter new patient information and update in the system.

Compliance, Quality & Safety

• Strictly adhere to NMC's regulations and policies, especially those related to infection control, patient safety, and JCI standards.
• 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.
• Identify problems and contribute to continuous improvement of the department's services.
• 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 needs.

Qualifications & Experience

• College Diploma in any discipline or related field.

Additional Information

• Shift work required, with timings varying according to department needs.
• Full details are available on the employer's original posting.