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 after-call actions and perform post call analysis for the claim follow-up
Assess and resolve enquiries, requests and complaints through calling to ensure that customer enquiries are resolved at first point of contact
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

JOB REQUIREMENTS

To be considered for this position, applicants need to meet the following qualification criteria:

1-4 Years of experience in accounts receivable follow-up / denial management for US healthcare customers
Fluent verbal communication abilities / call center expertise
Knowledge on Denials management and A/R fundamentals will be preferred
Willingness to work continuously in night shifts
Basic working knowledge of computers.
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.
Knowledge of Healthcare terminology and ICD/CPT codes will be considered a plus
We are hiring fresh graduates as well as experienced resources

Medical Billing / Specialist

Job Description