21 Aug
|
Leading
|
Padianallur
21 Aug
Leading
Padianallur
Key Responsibilities:
- Contact insurance payers to address claims (both denied and non -denied) after reviewing information from PMS and internal systems, aiming for resolution through payment, adjustments, or self -pay.
- Recognize and suggest process improvements, identify trends and issues, and escalate them to a Supervisor as needed.
- Adhere to workflow documentation, including updating trackers, issue logs, and trend logs according to standard operating procedures (SOPs).
- Participate in all training sessions to enhance understanding of Revenue Cycle Management (RCM).
- Resolve intricate patient account problems by investigating system timeline comments, payer reimbursements, and account transactions.
- Determine which accounts can be resolved by Analysts without requiring additional calls.
- Utilize logical thinking to spot trends and ensure accurate resolution of accounts.
- Identify payer -related issues, lead special projects to compile claim data for reprocessing,
and escalate complex payer issues to the lead billing specialist when necessary.