01Responsibilities
Investigate and resolve complex issues related to denied or unpaid medical claims promptly.Utilize in-depth knowledge of US healthcare billing processes to address and overcomechallenges. Conduct proactive follow-up with insurance companies to ensure timely and accuratereimbursement. Employ effective communication and negotiation skills to secure paymentfor outstanding claims. Verify and update insurance details, ensuring accurate information for claims processing.Navigate insurance portals and systems efficiently. Demonstrate expertise in denial management, analyzing reasons for denials, andimplementing strategies to minimize future occurrences. Collaborate with cross-functionalteams for effective resolution. Ensure strict adherence to healthcare regulations, including HIPAA, and maintainconfidentiality of patient information.
Stay updated on industry compliance standards.
02Requirements
Bachelors degree in statistics, business, finance, information systems or a related field. 1-5 years of experience in similar position. Excellent communication skills, both verbal and written. Thorough understanding of denial management, medical billing codes, insuranceregulations, and healthcare laws Review, analyze, and monitor RCM metrics to identify areas of improvement. Conduct research and problem-solving to assist practices in resolving issues promptly. Demonstrated interpersonal skills for effective collaboration within a team. Excellent problem-solving skills to identify and resolve issues promptly. .