Job Description – L2 Roles (Non-Voice)
1. Eligibility Resource
Experience in Eligibility Verification Process.
Good typing skills.
Ability to obtain eligibility information from various insurance portals.
Quick learner with good communication skills.
Minimum 12+ months of experience required.
Work from office is mandatory.
2. Charge Review/Entry
Experience in Demo & Charge Entry Process.
Exposure to working on Edits.
Understanding of CPT codes & claim specialties.
Familiarity with HCFA Forms.
Ability to clear scrubs/edits.
Minimum 18 months of experience required.
Ability to fix charges pended for various reasons.
Work from office is mandatory.
3. Edits/Clearing House/Claim Submission
Experience in Clearing House operations.
Exposure to working on Edits.
Strong understanding of Clearing Rejections & Payer Rejections.
Knowledge of how clearing houses function.
Ability to analyze rejections and provide inputs to managers to improve first-pass ratios.
Minimum 18 months of experience in Clearing House & Insurance Rejections.
Good understanding of Claim Forms & EDI Process.
Familiarity with HCFA Forms.
Ability to clear scrubs/edits.
Ability to fix charges pended for various reasons.
Work from office is mandatory.
4. Payment Posting & Credit Balance
Strong understanding of ERA Payments & working on ERA Exceptions/Kickbacks.
Knowledge of processing correspondence.
Experience in manual/ERA payment posting.
Ability to handle takebacks/off-sets.
Ability to meet client expectations.
Minimum 18 months of experience in Payment Posting.
Work from office is mandatory.
