- Perform pre-call analysis and check status by calling the payer or using IVR or web portal services
- Maintain adequate documentation on the client software to send 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 enquiries, requests and complaints through calling to ensure that customer enquiries are resolved at first point of contact
- Provide accurate product/ service information to 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, use appropriate codes to be used in documentation of the reasons for denials / underpayments
Job REQUIREMENTs
To be considered for this position, applicants need to meet the following qualification criteria:
- 1-4 Years of experience in accounts receivable follow-up / denial management for US healthcare customers
- Fluent verbal communication abilities / call center expertise
- 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 of working in a medical billing company and 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
