Susan Chacko

Handled medical insurance claims for inpatient and outpatient services and approvals

• Assisting with doctors and Insurance providers to minimize the percentage of rejections by updating approvals
• Working in NAPHIES program for getting proper approvals for Inpatient & Outpatient
• Managed daily operations and the expansion of the Outpatient/Inpatient Services Department
• Liaisons with payers for approval
• Liaison with Physicians for required medical justification for Inpatients/Outpatients if required
• Responsible for performing a variety of customer service or clerical functions for an outpatient facility; answered patient, family and visitor inquiries; takes accurate information for patient preregistration, arranged for referrals if necessary and scheduled appointments
• Responsible for maintaining all insurance files and updating files when necessary
• Responsible for doing a quarterly insurance audit and presenting the results and recommendations to management
• Responsible for negotiating insurance coverage limits and premiums with each provider
• Handling Inpatient and Outpatient insurance requirements (as per the insurance package & price list)
• Responsibilities: Manage, prepare and assess claims and developing and coordinating health care programs
• Ensure claims are settled in accordance with policy and company guidelines
• Promptly advise clients of decisions regarding claims
• Deny claims where applicable Liaise with repairers or suppliers when needed
• Apply creative problem-solving to selected claims, while adhering to policy definitions and regulations
• Develop and maintain relationships with range of stakeholders
• Handle claims electronically on in-house data management system
• Thorough documentation and general office administration
• Maintain and update Hospital Claims and Processing of all claims
• Maintaining daily and monthly reports & submitting to the company management
• Communicating between staff, patients and family
• Handling patient case management and giving better support
• Recruiting and training staff and creating schedules
• Developing patient goals and monitoring progress
• Maintaining patient confidentiality and quality care
• Responsible for maintaining an active database of all insurance information that was regularly reviewed by management
• Assisted in creating a semi-annual insurance audit that included suggestions on how the company could save money
• Responsible for seeking out information from other insurance carriers to compare to the rates and coverage the company was currently using
• Professional Outpatient& Inpatient Coordinator with planning and directing of business and personal affairs for high-level executives and top management
• Recognized for superior business decorum - poised in high pressure, fast-paced business environments
• Strong verbal and written communicator with strengths in opening relationships while maintaining confidentiality

• Handling Medical Insurance Claims and related work
• Receiving claims reports from hospitals online and entering in the system
• Maintain and update all Hospital Claims and Processing of all claims
• Medical Liability Evaluation, Maintain and Dealing with all care providers processed claims for confirmations and arranging payment
• Coordinating all pending payments & claims through Branch Medical Officers
• Verify /Correct in inaccuracies claims, reclaims processing and distribute to all hospitals
• Maintaining the medical records and invoices
• Maintaining daily and monthly reports & submitting to the company management

• Handling Medical Insurance Claims and related works
• Receiving claims reports from hospitals through online and entering in the system
• Maintain and update all Hospital Claims and Processing of all claims
• Verify /Correct in inaccuracies claims, reclaims processing and distribute to all hospitals

• Handling Medical Insurance Claims and related works
• Receiving claims reports from hospitals through online and entering in the system
• Maintain and update all Hospital Claims and Processing of all claims
• Verify /Correct in inaccuracies claims, reclaims processing and distribute to all hospitals

• Handling Medical Insurance Claims and related works
• Receiving claims reports from hospitals through online and entering in the system
• Maintain and update all Hospital Claims and Processing of all claims
• Medical Liability Evaluation, Maintain and Dealing with all care providers processed claims for confirmations and arranging payment
• Coordinating all pending payments & claims through Branch Medical Officers
• Verify /Correct in inaccuracies claims, reclaims processing and distribute to all hospitals
• Maintaining the medical records and invoices
• Maintaining daily and monthly reports & submitting to the company management

• Capacity of Hospital: 200 Beds
• Range of Services: ICU, Pediatric, Dental Clinic, Ophthalmology, Gen
• Medicine

• Capacity of Hospital: 350 Beds
• Range of Services: Cardiology, Internal Medicine, Urology, General Surgery, ENT, Gastroenterology, Orthopedics & Gynecology
• Ward/Department Worked: Intensive Coronary Care Unit.(ICCU)

• Capacity of Hospital: 350 Beds
• Range of Services: Cardiology, Pulmonology, Internal Medicine, Nephrology, Urology, General Surgery, Pediatric Unit, ENT, Dermatology, Gastroenterology, Orthopedics, Gynecology and Neurology
• Ward/Department Worked: Medical Surgical Intensive Care Unit.(MSICU)

• Capacity of Hospital: 300 Beds
• Range of Services: Cardiology, General Medicine, Gynecology, General Surgery, Pediatric, Urology, Dermatology, Ophthalmology
• Ward/Department Worked: General Ward