- Make outbound calls to insurance providers (US Payers) to follow up on unpaid/disputed claims.
- Investigate and resolve claim denials, underpayments, and rejections by analyzing EOBs and payer policies.
- Handle complex appeals and resubmissions of claims.
- Meet and exceed individual productivity and collection targets.
Required Skills & Experience:
- In-depth knowledge of US healthcare insurance (Medicare, Medicaid, HMO/PPO, Commercial).
- Proficient in denial management and the entire claims lifecycle.
- Strong understanding of CPT, HCPCS, and ICD-10 codes.
- Excellent communication skills for professional phone interactions.
- Experience working with major RCM software.
- Must work well withing a team and follow directions from TL