Clearing House - Tiruchchirappalli, India - TTS Business Services

Description

As a Clearing House Call Center Representative, you will be responsible for facilitating the smooth flow of healthcare claims and transactions between healthcare providers, insurance companies, and other entities.

Your primary role will involve handling incoming calls from various stakeholders, resolving inquiries, providing assistance, and ensuring accurate and efficient processing of transactions.

• Manage inbound calls from healthcare providers, insurance companies, and other stakeholders regarding claims processing, reimbursement, and related inquiries.
• Provide timely and accurate information regarding claim status, eligibility, benefits, and other relevant details.
• Assist in troubleshooting issues related to claim submission, rejections, denials, and appeals, working towards swift resolution.
• Utilize clearinghouse systems and tools to process, track, and manage healthcare transactions effectively.
• Collaborate with internal teams and external partners to address complex issues and escalate as necessary.
• Conduct training sessions for new hires and ongoing training for existing team members on clearinghouse processes, call center procedures, and healthcare industry regulations.
• Serve as a resource and mentor to junior team members, providing guidance and support to ensure team success.
• Maintain uptodate knowledge of healthcare regulations, industry trends, and clearinghouse best practices.
• Identify opportunities for process improvements and contribute to the development and implementation of solutions.
• Uphold high standards of customer service, professionalism, and confidentiality in all interactions.

• Previous experience working in a call center environment, preferably in healthcare or insurance industry.
• Proficiency in using clearinghouse systems and software for claims processing and transaction management.
• Strong understanding of healthcare terminology, coding, billing practices, and regulatory requirements.
• Excellent communication skills, both verbal and written, with the ability to convey complex information clearly and concisely.
• Demonstrated ability to handle high call volumes, multitask, and prioritize tasks effectively.
• Experience in training and development, with the ability to lead and mentor a team.
• Exceptional problemsolving skills and attention to detail, with a commitment to delivering accurate and timely results.
• Flexibility to adapt to changing priorities and work effectively in a fastpaced environment.
• Bachelor's degree in healthcare administration, business, or a related field preferred.
• Certification in healthcare revenue cycle management or related areas is a plus.

• Previous experience in a leadership role such as team lead or supervisor within a call center environment.
• Knowledge of industrystandard clearinghouse platforms and familiarity with EDI (Electronic Data Interchange) processes.
• Experience working with healthcare claims adjudication systems and electronic health records (EHR) software.
• Understanding of HIPAA (Health Insurance Portability and Accountability Act) and other healthcare compliance regulations.
• Proven track record of meeting or exceeding performance metrics and KPIs in a call center setting.

• Monday to Friday

• Tiruchirappalli, TN: Reliably commute or planning to relocate before starting work (required)

• Total work: Above 3+ Years (Team Lead/Trainer)

• Monday to Friday
• Night shift
• US shift
• Weekend availability