Roles and Responsibilities
Call Payer (Insurance) to resolve claims (denial/non-denial) after review from PMS, internal system & process toward resolution (Payment, Adjustment & self-pay).
l Identify potential process improvements, trends, issues and escalate to Supervisor through calling.
l Follow the Workflow documentation like SOPs Update tracker, Issue Log and Trend logs.
l Be part of all the training session to gain knowledge towards RCM.
l Resolve complex patient account issues requiring investigation of system timeline comments, payer reimbursements and account transactions
l Identify the accounts which does not require calling and can be fixed by Analyst to resolve
l Logical thinking to identify the trends, resolve accounts for an error free account
l Identify payer issues and leads special projects to aggregate claim data for payer reprocessing and escalate complex payer issues to the lead billing specialist as necessary
Recruiting For : Careernet Technologies
Contact Email : durga.kumari@careernet.in
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