Overview

- The Check Research Specialist is primarily responsible for analyzing collections, resolving non-payables, and handling bill inquiries for more complex issues. Specialists are responsible for insurance payer follow-up ensuring claims are paid according to client contracts. Complies with all applicable laws regarding billing standards

Responsibilities

- Follows up on claim rejections and denials to ensure appropriate reimbursement for our clients.

- Process assigned AR work lists provided by the manager in a timely manner.

- Write appeals using established guidelines to resolve claim denials with a goal of one contact resolution.

- Identified and resolved denied, non-paid, and/or non-adjudicated claims and billing issues due to coverage issues, medical record requests, and authorizations.

- Recommend accounts to be written off on Adjustment Request.

- Reports address and/or filing rule changes to the manager.

- Check the system for missing payments.

- Properly notates patient accounts.





- Review each piece of correspondence to determine specific problems.

- Research patient accounts.

- Reviews accounts and determines appropriate follow-up actions (adjustments, letters, phone insurance, etc.).

- Processes and follows up on appeals. Files appeals on claim denials.

- Inbound/outbound calls may be required for follow-up on accounts.

- Respond to insurance company claim inquiries.

- Communicates with insurance companies about the status of outstanding claims.

- Meet established production and quality standards as set by Ventra Health.

- Navigate websites to obtain EOBs.

- Performs special projects and other duties as assigned.

Qualifications

- High School Diploma or Equivalent.

- Two (2) year of experience posting insurance payments in a healthcare setting.

- Two (2) years of experience reading insurance Explanation of Advantages (EOB) statements preferred.

📌 Check Research Specialist (Chennai)
🏢 Ventra Health
📍 Chennai