Job description:
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 qualified phone interactions.
Experience working with major RCM software.
Must work well withing a team and follow directions from TL