Obtaining referrals and pre-authorizations as required for procedures.
Checking eligibility and benefits verification for treatments hospitalizations and procedures.
Reviewing patient bills for accuracy and completeness and obtaining any missing information.
Preparing to review and transmitting claims using billing software including electronic and paper claim processing.
Following up on unpaid claims within the standard billing cycle timeframe.
Checking each insurance payment for accuracy and compliance with contract discounts. Calling insurance companies regarding any discrepancy in payments if necessary.
Identifying and billing secondary or tertiary insurances.
Reviewing accounts for insurance of patient follow-up.
Researching and appealing denied claims.
Answering all patient or insurance telephone inquiries about assigned accounts.
Setting up patient payment plans and work collection accounts.
Updating billing software with rate changes.
Updating cash spreadsheets and running collection reports. Knowledge Skills and Abilities
Proficiency in the following areas is preferred:
Knowledge of insurance guidelines including HMO/PPO Medicare Medicaid and other payer requirements and systems.
Competent use of computer systems software and 10 key calculators.
Familiarity with CPT and ICD-10 Coding.
Effective communication abilities for phone contacts with insurance payers to resolve issues.
Customer service for interacting with patients about medical claims and payments including communicating with patients and family members of diverse ages and backgrounds.
Ability to work well in a team environment. Being able to triage priorities delegate tasks if needed and handle conflict reasonably.
Problem-solving skills to research and resolve discrepancies denials appeals collections.
A calm manner and patience working with either patients or insurers during this process.
Knowledge of accounting and bookkeeping procedures.
Knowledge of medical terminology is likely to be encountered in medical claims.
Maintaining patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
Ability to multitask.
Interested candidates can share their updated resume at [email protected] along with the following mandatory details… * Total Experience: * Relevant Experience: * Current CTC: * Expected CTC: * Notice period: * Willing to join within 15 days/30 days: * Reason for job change:
Posted By
Human Resources ESN Technologies (India) Pvt. Ltd.
