Role Description Overview:
The User is accountable to manage day to day activities of Denials Processing/ Claims follow-up/ Customer Service
Responsibility Areas:
- Should have experience into the relevant process-US Health Care -(AR Caller).
- Should have good knowledge into CPT Codes, denials, modifiers
- Should 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.
- Should have 12 months to 48 months of AR calling Experience.
- 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 / Undergraduates
- Excellent Communication Skills, Analytical & Good Listening Skills
- Basic Computer Skills