Roles and Responsibilities

Call Payer (Insurance) to resolve claims (denial/non-denial) after review from PMS, internal system & process toward resolution (Payment, Adjustment & self-pay).
Identify potential process improvements, trends, issues and escalate to Supervisor through calling.
Follow the Workflow documentation like SOPs Update tracker, Issue Log and Trend logs.
Be part of all the training session to gain knowledge towards RCM.
Resolve complex patient account issues requiring investigation of system timeline comments, payer reimbursements and account transactions
Identify the accounts which does not require calling and can be fixed by Analyst to resolve
Logical thinking to identify the trends, resolve accounts for an error free account
Identify payer issues and leads special projects to aggregate claim data for payer reprocessing and escalate complex payer issues to the lead billing specialist as necessary Roles and Responsibilities
Call Payer (Insurance) to resolve claims (denial/non-denial) after review from PMS, internal system & process toward resolution (Payment, Adjustment & self-pay).
Identify potential process improvements, trends, issues and escalate to Supervisor through calling.
Follow the Workflow documentation like SOPs Update tracker, Issue Log and Trend logs.
Be part of all the training session to gain knowledge towards RCM.
Resolve complex patient account issues requiring investigation of system timeline comments, payer reimbursements and account transactions
Identify the accounts which does not require calling and can be fixed by Analyst to resolve
Logical thinking to identify the trends, resolve accounts for an error free account
Identify payer issues and leads special projects to aggregate claim data for payer reprocessing and escalate complex payer issues to the lead billing specialist as necessary

Desired Candidate Profile

Minimum 1 Yr Call Center Experience
Graduates or Under Graduates
Good communication skills

Perks and Benefits

Quarterly Incentives
5 days a week
All US holidays along with Indian Holidays
Very lucrative employee referral policy Desired Candidate Profile.

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