Job Description:
1.Perform pre-call analysis and check status by calling the payer or using IVR or web portal Services
2.Maintain adequate documentation on the client software to send necessary documentation to Insurance companies and maintain a clear audit trail for future reference
3. Record after-call actions and perform post call analysis for the claim follow-up
4. Assess and resolve enquiries, requests and complaints through calling to ensure that customer enquiries are resolved at first point of contact.
5. 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
6.Receive payment information if the claims have been processed.
7. Analyze claims in case of rejections
8. Use appropriate codes to be used in documentation of the reasons for denials/ underpayments.
9.Ensure deliverables adhere to quality standards
Candidate Requirement:
Good Knowledge in Healthcare
Knowledge on various report generation
Knowledge on Denial management
Should work in night Shifts