01Responsibilities
Eligibility Verification:
- Verify patient eligibility and perks through payer portals and insurance calls
- Work on eligibility-related denials and exceptions
- Handle eligibility faxes and paper claims
- Review and resolve eligibility bucket scenarios
- Identify and resolve insurance-related issues impacting claims
- Ensure accurate insurance information to avoid future denials
- Maintain and update process documents/SOPs when required
Payment Posting:
- Perform ERA and EOB payment posting activities
- Work on electronic and paper remittances
- Handle payment posting from AR escalations
- Perform manual posting of EOBs received through email/fax
- Reconcile payer portals to ensure all payments are posted accurately
- Identify and report payment discrepancies and enrollment-related issues
Qualifications
- Good understanding of US Healthcare End-to-End RCM process
- Experience in Physician RCM preferred
- Strong communication skills (written and verbal)
- Good email and telephone etiquette
- Proficiency in MS Office (Word, Excel, PowerPoint, Outlook)
- Ability to work with insurance portals and payer websites
- Knowledge of reporting and process metrics based on experience level
Additional Information
- Transportation Faciity for Females/ Travel allowance for Males
- Health Insurance and Other Benefits .
