Process Associate - Mohali, India - i3synergist

i3synergist

Verified Company

Mohali, India

3 weeks ago

Posted by:

Deepika Kaur

beBee Recuiter

Description

This is a work from office position only.

Maximize insurance reimbursement for providers Must have work experience of Physician Billing process.
Discover root causes for medical insurance claim denial, underpayment, or delay and propose resolutions.
Interact with the USbased insurance carriers to followup on submitted claims, monitor unpaid claims, delayed processing, and underpayment plan, and execute medical insurance claim denial appeal process.
Must have work experience in Personal Injury and Workers Comp AR. Comfortable talking to attorney and adjustors.
Must be proficient in denial management and appeal process.
Must have excellent documentation skills for maintaining SOPs/guidelines/notes.
Review EOB/ERA denials and Patient history notes to understand and resolve denial on a claim.
Interact with USbased practice owners and clinicians on completing and correcting any missing or incorrect data on their insurance claims. Must be comfortable in AR calling and have relevant experience.
Identify claims that need balance transfer to patient and secondary balances or appropriate financial class for further resolution.
Should be able to track and follow up on claims within given TAT.
Must be comfortable with other voice process as per business requirement such as patient calling.
Completed graduation. Other formal education or training on a practice management system using patient accounting will be added advantage.
Relevant experience in a USA health care medical billing or RCM office capacity with related job duties and responsibilities.
Must have at least 1+ yrs. experience in physician billing; specifically, chiropractic, mental health, behavioral health etc.
Understand CMS1500 and UB04 claim formats.
Basic knowledge of collection laws, rules, and regulations.
Knowledge of medical billing software, preferably Tebra, Therapy Notes, Simple Practice, Theranest, ECW, Epic or any other similar.
Experience reading and interpreting and entering insurance EOBs. Knowledge of thirdparty payer referral requirements.

Competencies:

Excellent verbal and written English communication skills for interacting with USA based team members/ physicians/vendors/patients.
Professional and able to make a great impression on the phone. Required to understand, communicate & work regularly with USA based team.
Positive attitude and able to follow directions.
Ability to work well with others and facilitate teamwork and cooperation.
Willing to cross train and cross learn other areas of RCM.
Tact, diplomacy, and the ability to maintain confidentiality of company, client and patient information.
Must have very strong work ethic and excellent attention to detail.
Able to manage data in spreadsheets and CRM.
Prepare and analyze MIS reports for management review.