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, Dental 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 :
- 2-5 years of experience in US Healthcare BPO or related field.
- Solid knowledge of AR calling, denial management, and denials processes.
- Excellent communication skills for effective interaction with healthcare providers over phone calls.
- Notice Period: Immediate/15 days
- Qualification - Graduation required
- Shift: 6.30 PM to 3.30 AM (Own Commute)