ROLES AND RESPONBILITIES
- Responsible for calling Insurance companies (in the US) on behalf of doctors/physicians and follow up on outstanding Accounts Receivable.
- Calling Insurance Companies to follow up on Claims filed, to expedite payment.
- Should possess knowledge in Analysis, AR calling and denial management.
- Undertakes denial follow-up and appeals work wherever required.
- Reviewing, appealing unpaid and denied claims.
- Ability to document and take appropriate action of all claims which have been analyzed and followed-up in the required software.
- Verifying patient’s insurance coverage Answering patient billing questions.
- Should possess knowledge in eligibility and verification calls (E&B).
- Experience in navigating on call with insurance companies.
- Analyses outstanding claims and initiates collection efforts as per the aging report.
DESIRED CANDIDATE PROFILE
- Should have 0 to 2 years of experience in Medical Billing.
- Qualification: Any Graduates With strong Analytical Skills
- Strong Written & Oral Communication
- Immediate Joiners Preferred
- Should be in Vellore.
- Required Shift Flexibility
About Wonder Worth Solutions Pvt Ltd
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ROLES & RESPONSIBILITIES:
- Should understand the client requirements and specifications of the project and work accordingly.
- Should meet the productivity targets within the stipulated time.
- Timely input of demographic charges and time of service payment information.
- Expert ability to add specific data such as modifiers, payer specific information, including authorization criteria, CPT and ICD-9 code.
- Knowledgeable to append modifiers based on payer specifics, insurance and authorization requirements and referring physicians’ unique attributes.
- Reduce denials by correct use of modifiers, mapping, and linking codes with services.
- Responsible for the processing and discrepancy reconciliation and closing of charge batches across all systems.
Desired Candidate Profile:
- Should have 0 to 1 years of experience in Medical Billing.
- Qualification : Any Graduates With strong Analytical Skills
- Strong Written & Oral Communication
- Adequate Knowledge with MS Office Package
- Requires Fluency in typing
NOTE: Immediate Joiners Preferred ,Should be in Vellore.
ROLES AND RESPONSIBILITIES
- Any Life Science Graduate [B.Sc/M.Sc (Biology, Micro-Biology, Biotechnology, Biochemistry, Nursing), B.Pharmacy/M.Pharmacy, B.P.T, B.Tech (Biotechnology, Biochemistry)]
- Candidate's should have good communication & analytical skills
- Should be good at Medical Terminologies (Physiology and Anatomy).
- Shift flexibility required.
- Basic knowledge in MS office preferred.
Position Insurance Follow Up - 2 (ISP-2)
Shift US Shift (05:30 PM to 03:00 AM)
Job function· Checking denials from EOBs, ERAs by calling the Insurance Companies. · Calling the insurance companies for the specification of denials. · Reprocessing the claim over the phone or reopening the claims on the online portals · Filing an appeal to the insurance companies with the required information · Checking status of the appeal filed and reprocessed claims through IVR, Calls and online payer’s portal · Refilling corrected claims with coding/demographic/authorization/referral corrections. · Disputing with the insurance companies on incorrect denials. · Working on FTH (Fix The Hole) to prevent future denials · Tasking to the clients and other teams for required information · Preparing Trending Analysis on the denials and escalating to Supervisors · Finding updates from payers via call or online for billing related information and sharing with the concern team/department to prevent denials. · Responsible for updating any internal databases, electronically storing and organizing patients' records, billing details, and registration forms.
Education +2 or Graduate in any stream
Training/Work
experience Billing & collections training and/or 1 year of industry experience in the relevant function
Other specifications Good English communication (reading, writing, listening, speaking) Understanding of US healthcare, HIPAA Good at Operating Computer - software and MS office
Capable of task execution based on work instructio