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 aftercall actions and perform post call analysis for the claim follow-up
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
Prepare, review, and transmit claims using AR software, including electronic and paper claim processing
Review patient bills for accuracy and completeness and obtain any missing information
Preferred candidate profile
Any graduation
2 to 4 years of Years of experience in accounts receivable follow-up / denial management for US healthcare customers
Proficient computer skills. Excellent communication skills, both verbal and written
Strong people skills & Outstanding organizational skills
Ability to maintain the confidentiality of information
Willingness to work continuously in night shifts
Job Classification
Industry: BPM / BPOFunctional Area / Department: Healthcare & Life SciencesRole Category: Healthcare & Life Sciences - OtherRole: Healthcare & Life Sciences - OtherEmployement Type: Full time