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Perform pre-call analysis and check status by calling the payer or using IVR or web portal services
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Maintain adequate documentation on the client software to send necessary documentation to insurance companies and maintain a clear audit trail for future reference
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Record after-call actions and perform post call analysis for the claim follow-up
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Assess and resolve enquiries, requests and complaints through calling to ensure that customer enquiries are resolved at first point of contact
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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
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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:
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Fluent verbal communication abilities / call center expertise
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Knowledge on Denials management and A/R fundamentals will be preferred
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Willingness to work continuously in night shifts
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Basic working knowledge of computers.
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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.
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Knowledge of Healthcare terminology and ICD/CPT codes will be considered a plus
