Job Description

• Perform pre-call analysis and check status by calling the payer or using IVR or web portal services

• Maintain adequate documentation on the client software to send necessary documentation to insurance companies and maintain a clear audit trail for future reference

• Record after-call actions and perform post call analysis for the claim follow-up

• Assess and resolve enquiries, requests and complaints through calling to ensure that customer enquiries are resolved at first point of contact

• Provide accurate product/ service information to customer, research available documentation including authorization, nursing notes, medical documentation on client's systems, interpret explanation of benefits received etc prior to making the call

• Perform analysis of accounts receivable data and understand the reasons for underpayment, days in A/R, top denial reasons, use appropriate codes to be used in documentation of the reasons for denials / underpayments

Job REQUIREMENTs

To be considered for this position, applicants need to meet the following qualification criteria:

• 1-4 Years of experience in accounts receivable follow-up / denial management for US healthcare customers

• Fluent verbal communication abilities / call center expertise

• Knowledge on Denials management and A/R fundamentals will be preferred

• Willingness to work continuously in night shifts

• Basic working knowledge of computers.

• Prior experience of working in a medical billing company and use of medical billing software will be considered an advantage. We will provide training on the client's medical billing software as part of the training.

• Knowledge of Healthcare terminology and ICD/CPT codes will be considered a plus

• We are hiring fresh graduates as well as experienced resources

GROW YOUR CAREER WITH Pacific BPO, an access healthcare company