17 Aug
|
Important Business
|
Chennai
17 Aug
Important Business
Chennai
Roles and Responsibilities:
- 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 explicit 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.
- Ensuring the daily assigned accounts are resolved/ worked on.
- Escalate difficult collection situations to Team Leaders situations and seek education and instruction.