Full Description
Calling AR Callers Get a Part of the Medical Billing Team
Job Description
Duties:
Insurance Follow-up: Make proactive calls to insurance payers (such as Aetna, Blue Cross, and Medicare) to inquire about the status of unresolved claims that have taken longer than expected to process.
Denial Management: Examine denial codes (such as CO-16 and PR-1) to determine the reasons behind a claim's rejection and take the necessary corrective action.
Claims Resubmission: Work with the billing team to include missing modifiers, attach medical records, or fix demographic problems before resubmitting the "clean claim" for processing.
Appeal Processing: For claims that have been erroneously rejected, draft and submit proper appeal letters, making sure to include all clinical supporting documentation.
Documentation: Keep thorough records of all conversations with insurance agents, including the call reference number, the representative's name, and the estimated time of arrival.
Patient Responsibility Coordination: Determine whose claims deductibles or co-insurance have been transferred
to the patient and forward them to the patient billing division.
Payer Portal Navigation: Track claim lifecycles, confirm eligibility, and get EOBs (Explanation of Benefits) by using web-based insurance portals.
Trend Analysis: To increase front-end billing accuracy, find recurrent refusal patterns from particular insurance carriers and notify management of them.
Focus Skills:
Communication: Proficient in both written and spoken English, with a neutral accent for speaking with US insurance agents.
US Healthcare Knowledge: A thorough comprehension of HIPAA rules, the fundamentals of CPT/ICD-10 coding, and the distinctions between federal, PPO, and HMO insurance.
Persistence and Negotiation: The capacity to deal with lengthy wait times and confront insurance agents to guarantee that claims are reprocessed appropriately.
Analytical Thinking: The ability to read an EOB or ERA and identify the precise cause of non-payment.
Apply now to become an integral part of our growing team!
With Regards,
HR - Maria
88708 33430
infohrmaria04@gmail.com