About the role
- Review and analyze the assigned outstanding receivables portfolio to identify unresolved claims.
- Manage and resolve outstanding and denied claims by coordinating effectively with insurance companies.
- Follow up promptly to obtain additional information required for claim resolution.
- Ensure all claims are resolved within established timelines and adhere to defined Service Level Agreements (SLAs).
- Perform website checks and handle non-callable denials to optimize receivables recovery.
Skills and abilities:
- Working on website related claims and action based on coding team responses.
- All non-callable denials, demographic and eligibility denials need to be worked
- Ensure Daily Productivity targets are met at the required quality level on the assigned inventory.
- Perform timely follow up on claims to avoid revenue loss, Prioritize the pending claims for calling from the aging bucket
- Review claims that have not been paid by insurance companies.
- Check insurance information provided by patient if it is insufficient or unclear.
Follow the guidelines and applicable rules while calling insurance companies for confidentiality and HIPAA compliance. - Escalate difficult collection situations to management in a timely manner, Handling patients billing queries and updating their account information.
- Post cash and write off the contractual adjustments accordingly while working on the accounts.
- Meeting daily/weekly and monthly targets set for an individual.
Qualifications: Graduation in any stream
Experience: BPO Experience: 3-6 years
US Healthcare AR experience
Communication Skill: Excellent written (documentation) and oral communication skill