Job Summary:

The ideal candidate will be a qualified medical doctor or nurse with 3-5 years of experience in the insurance industry and/or hospital setting. This role requires a deep understanding of ICD and CPT coding, medical billing guidelines, and proficiency in managing insurance claims.

The Assistant Insurance Manager will play a key role in ensuring accurate and efficient processing of insurance claims, while also supporting the insurance department in various administrative tasks.

Key Responsibilities:

• Oversee and manage the day-to-day operations of the insurance department, including the submission, resubmission, and follow-up of insurance claims.
• Ensure accurate coding of medical services using ICD and CPT codes in compliance with current medical billing guidelines.
• Collaborate with medical staff, finance, and IT teams to resolve discrepancies and optimize the billing process.
• Conduct audits of medical claims to identify and correct errors, ensuring compliance with insurance policies and regulations.
• Develop and maintain detailed reports using Excel to monitor claim status, reimbursement trends, and department performance.
• Create and deliver presentations using PowerPoint to communicate key insights and updates to senior management.
• Assist in the training and development of insurance department staff on billing procedures and guidelines.
• Stay updated with changes in insurance policies, medical coding standards, and billing regulations to ensure compliance.

Qualifications:

• Medical doctor or nurse with 3-5 years of experience in an insurance company and/or hospital setting.
• In-depth knowledge of ICD and CPT coding, as well as medical billing guidelines.
• Strong analytical skills with proficiency in Excel and PowerPoint.
• Excellent communication and interpersonal skills.
• Ability to work collaboratively with cross-functional teams.
• Attention to detail and a commitment to accuracy.

Skills

Preferred Qualifications:

• Previous experience in a supervisory or management role within an insurance or healthcare setting.
• Certification and/or Course in medical coding or billing is preferred.