Role Description Overview:
The User is accountable to manage day to day activities of Denials Processing/ Claims follow-up/ Customer Service.
Responsibility Areas:
· Handle US Healthcare providers/ Physicians/ Hospital's Accounts Receivable.
· To work closely with the team leader.
· Ensure that the deliverables to the client adhere to the quality standards.
· Responsible for working on Denials, Rejections, LOA's to accounts, making required corrections to claims.
· Calling the insurance carrier & Document the actions taken in claims billing summary notes.
· To review emails for any updates
· Identify issues and escalate the same to the immediate supervisor
· Update Production logs
· Strict adherence to the company policies and procedures.
Requirements:
· Sound knowledge in Healthcare concept.
· Must have 1 to 3 years of AR calling Experience and experience in handling Prior Authorization
· Excellent Knowledge on Denial management.
· Should be proficient in calling the insurance companies.
· Ensure targeted collections are met on a daily / monthly basis
· Meet the productivity targets of clients within the stipulated time.
· Ensure accurate and timely follow up on pending claims wherein required.
· Prepare and Maintain status reports
Skills & Education:
· Any degree
· Excellent Communication Skills, Analytical & Good Listening Skills
· Basic Computer Skills