Key Responsibilities:
- Prepare and submit medical claims to insurance companies accurately and in a timely manner.
- Ensure that all required documentation, such as medical records and invoices, is attached to support the claims.
- Regularly follow up on unpaid or underpaid claims with insurance companies using various communication channels, including phone calls and written correspondence.
- Investigate and address claim denials promptly, determining the reasons for denials and taking corrective actions to reprocess or appeal denied claims.
- Communicate effectively with insurance representatives to resolve claim issues and obtain necessary information.
- Establish and maintain positive relationships with insurance companies to facilitate smoother claims processing.
- Communicate with patients regarding their account balances, explaining any insurance-related matters or financial responsibilities.
- Assist patients with questions related to billing and insurance, providing clear and accurate information.
- Follow the organization's policies, procedures, and compliance standards to ensure adherence to healthcare regulations.
- Stay informed about changes in healthcare regulations that may impact billing practices and AR processes.
- Any graduate with a focus on healthcare administration or related fields preferred.
- Prior experience in medical billing or AR processes is highly desirable; calling experience would be an added advantage.
- Fluent verbal communication abilities to effectively interact with clients, insurance representatives, and team members.
- Willingness to work in night shifts (US shift) to accommodate client needs.
- Good understanding of the overall Revenue Cycle Management to effectively work on AR processes.
- Strong analytical and problem-solving skills, with attention to detail to ensure accuracy in claims processing.
- Ability to work independently and manage multiple priorities in a fast-paced environment.
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