Location: Bengaluru
Experience: 1 to 5 Years
Work mode: work from office
Notice Period: Immediate joiners preferred
Shift: Night Shift & Day Shift
Key Skills Required:
- Proficiency in Physician Billing (CMS-1500)
- In-depth knowledge of CMS-1500 claim forms & workflows
- Strong expertise in Denial Management
- Excellent communication skills
Job Responsibilities:
- Responsible for calling Insurance companies (in US) on behalf of doctors/physicians and follow up on outstanding Accounts Receivable
- To prioritize the pending claims for calling from the aging basket
- Should be able to convince the claims company (payers) for payment of their outstanding claims.
- To check the appropriateness of the insurance information given by the patient if it is inadequate or unclear.
- To make a physical call by following the international norms and applicable rules for confidentiality and HIPAA compliance
- Escalate difficult collection situations to management in a timely manner.
- Review provider claims that have not been paid by insurance companies
- Handling patient’s billing queries and updating their account information.
- Post cash and write off the contractual adjustments accordingly while working on the accounts.
- Meeting daily/weekly and monthly targets set for an individual.
- In case the patient does not have sufficient insurance coverage for the medical procedure or if the patient is in any way not eligible for coverage, transfer the outstanding balance to the patient.
- In case the claim has already been paid by the insurance company, request insurance company/ TPA to send EOB (Explanation of Benefits) through fax/ mail.
- Sound knowledge of U.S. Healthcare Domain (Provider side)