Roles and Responsibilities
- Follow up on submitted claims, monitor unpaid claims, and identify underpaid and unbilled claims, ensuring all necessary corrections and documentation are completed.
- Analyze claims and manage denials effectively.
- Review Explanation of Benefits (EOB) and Electronic Remittance Advice (ERA) denials, along with patient history notes, to understand and resolve discrepancies in claims.
- Identify claims requiring balance transfers to patients and secondary
balances, as well as appropriate financial classifications for further resolution. - Track and follow up on claims due for future review within the designated time frames.
- Identify global issues impacting single or multiple patient accounts.
Required Experience, Skills, and Qualifications
- A minimum of 1 year of Accounts Receivable experience is mandatory.
- Strong knowledge of denial management concepts is essential.
- Excellent communication skills are required.
- Flexibility to work night shifts is necessary.
- Candidates available for immediate joining or those who can serve a notice
- period of up to 30 days will be considered.
