Revenue cycle management ,AR Calling, HIPAA, US Healthcare,RCM

Denial Management

Job Description:

• Responsible for calling Insurance companies (in US) on behalf of doctors/physicians and follow up on outstanding Accounts Receivable
• To prioritize the pending claims for calling from the aging basket
• Should be able to convince the claims company (payers) for payment of their outstanding claims.
• To check the appropriateness of the insurance information given by the patient if it is inadequate or unclear.
• To make a physical call by following the international norms and applicable rules for confidentiality and HIPAA compliance.
• Escalate difficult collection situations to management in a timely manner.
• Review provider claims that have not been paid by insurance companies.
• 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.

Desired Profile: Ability to prioritize and manage work queue.

• Ability to work independently as well as in a team environment.
• Strong analytical and problem-solving skills

1. Excellent communication skills
2. Graduates /Undergraduates (Except B.Tech 2018 & 2019 Pass Outs)
3. Ready to show good stability
4. Ready to work in any Shift
5. Strong analytical skills

Job description

1. Use data to produce and submit claims to insurance companies
2. Check authorization for procedures to be performed.
3. Verify patients insurance coverage
4. Submit medical claims to insurance companies on a timely basis.
5. Follow up on unpaid claims within standard billing cycle time frame.
6. Review patient bills for accuracy and completeness and obtain missing information
7. Analyze reports and update daily status reports
8. Communicate with clients over phone and email.
9. Training will be provided.

1. Under Graduate / Graduate (any)
2. Good English communication skills
3. Microsoft Office and Excel.

Job description

1. Assist in processing orders for medical exams and procedures by checking patient medical eligibility and determine if the specialist location is in network with a particular health plan.
2. Communicate with insurance payers via fax, telephone, or online to determine if authorization is required for specific medical procedures and obtain authorization if necessary.
3. Work with insurance payers via fax, telephone, or online to initiate and complete authorization requests, and keep detailed notes throughout the process about the progress of the order.
4. Communicate with clients to obtain additional information in order to complete eligibility verification or processing an order.
5. Work with the AuthCentral Supervisor and Manager to take on tasks or projects to fulfill the additional needs of the Service Center. This may include assisting team members in different work queues, compiling reports, and quality assurance.

1. Bachelors Degree or equivalent work experience preferred
2. Min 8 Months of experience into the same industry
3. Strong attention to detail
4. Positive attitude including patience and grace under pressure
5. Good organizational and time management skills
6. Strong ability to multitask
7. Eagerness to learn, work hard, and have fun
8. Ability to adapt in an ever-changing environment
9. Excellent customer service and communication skills
10. Computer proficiency and ability to learn new software programs quickly

1. Excellent communication skills
2. Graduates /Undergraduates
3. Ready to show good stability
4. Ready to work in any Shift
5. Strong analytical skills

JOB DESCRIPTION –

1. Review Patient chart and ensure codes are applied correctly during the medical billing process, which includes removing the information from documentation, assigning the appropriate codes, and creating a claim to be paid by insurance carriers.
2. Assign codes to diagnoses and procedures, using ICD 10 (International Classification of Diseases) and CPT (Current Procedural Terminology) codes
3. Ensure codes are accurate and sequenced correctly in accordance with government and insurance regulations
4. Review the previous day's batch of patient notes for evaluation and coding
5. Ensure that all codes are current and active
6. Multi-Specialty Coding exposure

1. CPC certification preferable
2. Must have thorough knowledge on Diagnosis codes, procedure codes & medical services.
3. Must have solid foundation of anatomy and physiology
4. Should possess good oral and written communication in English.
5. Good analytical and problem solving skills.
6. eCW/Cerner/Epic software exposure preferable