Job Description :
- Perform pre-call analysis and check the status by calling the payer or using IVR or web portal services
- Maintain adequate documentation on the client software to send the necessary documentation to insurance companies and maintain a clear audit trail for future reference
- Record after-call actions and perform post-call analysis for the claim follow-up
- Assess and resolve inquiries, requests, and complaints through calling to ensure that customer inquiry are resolved at the first point of contact
- Provide accurate product/ service information to the customer, research available documentation including authorization, nursing notes, medical documentation on client's systems, interpret explanation of benefits received, etc prior to making the call
- Perform analysis of accounts receivable data and understand the reasons for underpayment, days in A/R, top denial reasons, and use appropriate codes to be used in documentation of the reasons for denials/underpayments
Eligibility :
To be considered for this position, applicants need to meet the following qualification criteria:
- 1+ Years of experience in accounts receivable follow-up/denial management for US healthcare customers
- Fluent verbal communication abilities
- Knowledge on Denials management and A/R fundamentals will be preferred
- Willingness to work continuously in night shifts
- Basic working knowledge of computers.
- Prior experience working in a medical billing company and the use of medical billing software will be considered an advantage. We will provide training on the client's medical billing software as part of the training.
- Knowledge of Healthcare terminology and ICD/CPT codes will be considered a plus
- The preferred Qualification should be graduate
