90+ Vizza Insurance Broking Services Interview Questions and Answers

COBRA is a federal law that allows employees to continue their health insurance coverage after leaving their job. Copay is a fixed amount paid by the insured for each healthcare service. Deductibles are the amount the insured must pay out of pocket before the insurance company starts covering costs. HIPAA is a federal law that protects the privacy and security of patient health information.

• COBRA: Federal law for continuing health insurance after job loss

• Copay: Fixed amount pa...read more

There are 7 steps in revenue cycle management: Pre-authorization, Patient registration, Charge capture, Claim submission, Payment posting, Denial management, and Reporting.

• Pre-authorization: Obtaining approval from insurance companies before providing services.

• Patient registration: Collecting patient information and insurance details.

• Charge capture: Recording services provided and creating charges for billing.

• Claim submission: Submitting claims to insurance companies for reim...read more

An analyst is responsible for collecting, analyzing, and interpreting data to provide insights and recommendations to improve business performance.

• Collecting and organizing data from various sources

• Analyzing data using statistical methods and software

• Interpreting data to identify trends, patterns, and insights

• Developing reports and presentations to communicate findings and recommendations

• Collaborating with stakeholders to understand business needs and goals

• Continuously monito...read more

Timely filing denial is calculated from the date of service.

• Timely filing denial is calculated based on the date of service provided on the claim.

• Insurance companies have specific time frames within which claims must be submitted after the date of service.

• If a claim is submitted after the timely filing deadline, it may be denied for timely filing.

• Timely filing deadlines can vary depending on the insurance company and type of insurance plan.

• It is important for providers to be ...read more

CPT codes are used to identify medical procedures and services, while diagnosis codes are used to identify medical conditions.

• CPT codes are five-digit numeric codes that describe medical procedures and services.

• Diagnosis codes are alphanumeric codes that identify medical conditions.

• CPT codes and diagnosis codes are used together to bill insurance companies for medical services.

• Examples of CPT codes include 99213 for a standard office visit and 45378 for a colonoscopy.

• Examples...read more

Authorization dental is the process of obtaining approval from a dental insurance provider before receiving certain dental treatments.

• Authorization dental is required for certain procedures like crowns, bridges, and orthodontic treatments.

• The process involves submitting a treatment plan to the insurance company for review and approval.

• On-call scenario: A patient calls the dental office requesting a procedure that requires authorization. The office staff informs the patient th...read more

Co-pay is a fixed amount paid by the patient for a covered service, co-insurance is a percentage of costs shared between patient and insurer, deductible is the amount patient pays before insurance kicks in, out of pocket is the total amount patient pays for covered services.

• Co-pay is a set amount paid by the patient for each covered service, such as $20 for a doctor's visit.

• Co-insurance is the percentage of costs shared between the patient and the insurance company, such as 8...read more

The End-to-End Revenue Cycle involves multiple steps from patient registration to payment collection.

• Patient registration and scheduling

• Insurance verification and authorization

• Charge capture and coding

• Claim submission

• Payment posting and reconciliation

• Denial management and appeals

• Patient billing and collections

RCM stands for Revenue Cycle Management, which is the process of managing the financial aspects of healthcare services.

• RCM involves managing patient registration, insurance verification, coding and billing, and collections.

• It helps healthcare providers optimize their revenue and improve cash flow.

• RCM also ensures compliance with regulations and reduces the risk of errors and fraud.

• Examples of RCM software include Epic Systems, Cerner, and Allscripts.

There are two parts in dedicate: de and dicate. De means down or away, and dicate means to say or speak.

• De means down or away

• Dicate means to say or speak

Modified refers to changes made to something to improve its functionality or performance.

• Modification can involve altering existing features or adding new ones

• It is important because it allows for continuous improvement and adaptation to changing needs

• In software development, modified code is often used to fix bugs or add new functionality

PR stands for Public Relations, which is the practice of managing communication between an organization and its publics.

• Public Relations (PR) is the strategic communication process that builds mutually beneficial relationships between organizations and their publics.

• Types of PR include media relations, crisis communication, internal communication, community relations, and investor relations.

• Examples of PR activities include press releases, social media management, event plann...read more

Cobra, copay, and deduction are terms related to healthcare insurance.

• COBRA stands for Consolidated Omnibus Budget Reconciliation Act and allows employees to continue their health insurance coverage after leaving their job.

• Copay is a fixed amount paid by the patient for a covered healthcare service, while the insurance company pays the rest.

• Deduction is the amount of money that is subtracted from an employee's paycheck to pay for their health insurance premium.

Modifier 76 is used for repeat procedures by the same physician on the same day. Modifier 77 is used for repeat procedures by a different physician on the same day.

• Modifier 76 is used to indicate that a procedure or service was repeated by the same physician on the same day.

• Modifier 77 is used to indicate that a procedure or service was repeated by a different physician on the same day.

• These modifiers are used to distinguish between separate procedures performed on the same d...read more

There are three main types of Federal Insurance: Medicare, Medicaid, and Social Security Disability Insurance.

• Medicare provides health insurance for people aged 65 and older, as well as certain younger individuals with disabilities.

• Medicaid is a joint federal and state program that helps with medical costs for some people with limited income and resources.

• Social Security Disability Insurance (SSDI) provides benefits to individuals who are unable to work due to a disability.

R1 is a revenue cycle management company that provides end-to-end solutions for healthcare providers.

• R1 helps healthcare providers optimize their revenue cycle management processes

• They offer services such as patient registration, coding and billing, and collections

• R1's technology platform uses data analytics and automation to improve efficiency and accuracy

• They work with a variety of healthcare organizations, including hospitals, physician groups, and ambulatory surgery cente...read more

Dedicate eligibility refers to the qualifications or requirements needed to be considered for a dedicated position or task.

• Dedicate eligibility may include specific skills, experience, education, or certifications.

• For example, a Senior Analyst position may require a minimum of 5 years of relevant experience in the field.

• Eligibility criteria can vary depending on the organization and the nature of the role.

Non cover services can be handled by clearly communicating with clients, offering alternative solutions, and managing expectations.

• Clearly communicate with clients about the services that are not covered by their plan

• Offer alternative solutions or services that may be covered by their plan

• Manage client expectations by explaining the reasons for non-coverage and providing options for moving forward

Denial examples and coping strategies in a professional setting

• Acknowledge the denial and its impact on decision-making

• Seek feedback from colleagues or supervisors to gain perspective

• Practice self-reflection and identify any underlying fears or insecurities contributing to denial

• Develop a plan of action to address the issue causing denial

• Consider seeking support from a mentor or coach for guidance

Copy and coins is not a commonly used term. It may refer to a specific jargon in a particular industry.

• Copy and coins may refer to a specific term used in a particular industry, such as advertising or marketing.

• Without more context, it is difficult to provide a specific answer.

• It is possible that the interviewer may have misspoken or meant to ask a different question.

RCM process stands for Revenue Cycle Management, which involves managing the financial aspects of healthcare services.

• RCM process involves managing the financial aspects of healthcare services from patient registration to final payment.

• It includes tasks such as verifying insurance coverage, submitting claims, and following up on unpaid claims.

• Efficient RCM process helps healthcare organizations optimize revenue and improve cash flow.

• It also involves coding and billing complia...read more

Different payer types include government payers, commercial payers, and self-pay patients.

• Government payers: Medicare, Medicaid, TRICARE

• Commercial payers: Blue Cross Blue Shield, Aetna, Cigna

• Self-pay patients: Individuals who pay for healthcare services out of pocket

Timely filings refer to the submission of claims within a specific time frame.

• Insurance companies have specific deadlines for submitting claims

• Failing to submit claims within the deadline can result in denial of payment

• Timely filings vary depending on the type of insurance and the state

• For example, Medicare has a timely filing limit of one year from the date of service

US healthcare is a complex system that involves private and public insurance, healthcare providers, and government regulations.

• The US healthcare system is a mix of private and public insurance programs.

• Private insurance is typically provided by employers or purchased individually.

• Public insurance includes Medicare for seniors and Medicaid for low-income individuals.

• Healthcare providers include hospitals, clinics, and private practices.

• The government regulates healthcare throu...read more

Different types of insurance include health, life, auto, home, travel, pet, and liability insurance.

• Health insurance covers medical expenses and treatments.

• Life insurance provides financial support to beneficiaries in case of the policyholder's death.

• Auto insurance covers damages and injuries in case of a car accident.

• Home insurance covers damages to the house and personal belongings.

• Travel insurance covers unexpected events during travel, such as trip cancellation or medical...read more

I want to join r1rcm because of their reputation for providing excellent healthcare revenue cycle management services.

• R1RCM is known for their expertise in revenue cycle management

• I am impressed by their track record of helping healthcare organizations improve their financial performance

• I believe my skills and experience align well with the opportunities at r1rcm

Commercial insurance plan types include PPO, HMO, EPO, and POS.

• Preferred Provider Organization (PPO) - offers a network of healthcare providers and allows members to see out-of-network providers at a higher cost

• Health Maintenance Organization (HMO) - requires members to choose a primary care physician and get referrals for specialists

• Exclusive Provider Organization (EPO) - similar to a PPO but does not cover any out-of-network care

• Point of Service (POS) - combines features of...read more

Medicare eligibility refers to the criteria individuals must meet in order to qualify for Medicare benefits.

• Individuals aged 65 and older are typically eligible for Medicare

• Younger individuals with certain disabilities or medical conditions may also be eligible

• Medicare eligibility is also extended to individuals with end-stage renal disease (ESRD)

• Citizens or permanent residents of the United States are generally eligible for Medicare

Copay is a fixed amount paid by the patient for a covered healthcare service, while coinsurance is a percentage of the cost shared between the patient and the insurance company.

• Copay is a set amount paid by the patient at the time of service (e.g. $20 for a doctor's visit).

• Coinsurance is a percentage of the total cost of a covered service that the patient pays after meeting the deductible (e.g. 20% of the cost of a hospital stay).

• Both copay and coinsurance are forms of cost-s...read more

RCM stands for Revenue Cycle Management, which is the process of managing claims, payments, and revenue generation in healthcare. FCC stands for Federal Communications Commission, which regulates communications in the US.

• RCM involves managing patient billing, claims processing, and revenue generation in healthcare organizations.

• FCC regulates communications in the US, including radio, television, wire, satellite, and cable.

• Examples of RCM software include Epic Systems, Cerner,...read more

Denials can be categorized into different types based on the reason for denial.

• Medical necessity denials

• Coding denials

• Duplicate billing denials

• Timely filing denials

• Authorization denials

• Non-covered service denials

I would approach the situation by seeking guidance and training from experienced colleagues and resources.

• Ask for guidance and training from experienced colleagues and resources

• Take notes and ask questions to clarify any confusion

• Practice and apply the new process with supervision

• Seek feedback and adjust accordingly

• Stay positive and open-minded towards learning new skills

Yes

• I have extensive experience in US healthcare RCM (Revenue Cycle Management)

• I have worked with various healthcare organizations, managing their financial processes and optimizing revenue generation

• I am well-versed in medical coding, billing, claims processing, and reimbursement methodologies

• I have successfully implemented RCM strategies to improve cash flow, reduce denials, and enhance overall financial performance

• I have a strong understanding of healthcare regulations, suc...read more

I handled 10 clients and the largest AR outstanding value was $500,000 in my previous organization.

• I managed a portfolio of 10 clients in my previous organization.

• The largest AR outstanding value I handled was $500,000.

• I ensured timely payments and resolved any billing issues.

• I maintained a good relationship with clients to ensure repeat business.

• I also implemented new processes to improve AR collections.

RCM process involves managing the financial aspects of healthcare services, including billing, claims processing, and revenue generation.

• Identifying patient demographics and insurance information

• Submitting claims to insurance companies for reimbursement

• Following up on unpaid claims and denials

• Ensuring compliance with regulations and coding guidelines

• Analyzing revenue cycle data to improve efficiency and profitability

Customer service is providing assistance and support to customers to ensure their satisfaction and loyalty.

• Listen actively and empathize with the customer's concerns

• Apologize for any inconvenience caused and take ownership of the issue

• Offer a solution or alternative to resolve the problem

• Follow up with the customer to ensure their issue has been resolved

• Maintain a positive and professional attitude throughout the interaction

Deferred revenue expenditure is recorded as an asset in the balance sheet and is gradually expensed over a period of time.

• Deferred revenue expenditure is an expense that is incurred in one accounting period but its benefits are realized over multiple periods.

• It is recorded as an asset in the balance sheet and is gradually expensed over a period of time.

• Examples of deferred revenue expenditure include advertising expenses, research and development costs, and pre-opening expens...read more

If two physicians are mentioned in the charts, we need to determine the appropriate action.

• Check if both physicians are primary care providers or specialists

• Verify if the physicians have conflicting treatment plans

• Consult with the healthcare team to clarify any discrepancies

• Ensure accurate documentation of the involvement of each physician

R1RCM is a healthcare revenue cycle management company. The role is for a data analyst position.

• R1RCM specializes in providing revenue cycle management services to healthcare providers.

• The company uses advanced technology and analytics to optimize revenue cycle performance.

• As a data analyst, the role involves analyzing and interpreting healthcare data to identify trends and insights.

• The data analyst will work closely with other teams to develop strategies for improving revenu...read more

Online shopping is the process of purchasing goods or services over the internet.

• Online shopping has become increasingly popular due to its convenience and accessibility.

• Customers can browse and purchase products from a variety of online retailers.

• Many online retailers offer free shipping and easy returns, making the shopping experience more convenient.

• Online shopping has also led to the rise of e-commerce giants like Amazon and Alibaba.

• Security concerns such as fraud and ide...read more

I am looking for a challenging role with growth opportunities in the healthcare industry.

• Seeking a challenging role

• Interested in growth opportunities

• Passionate about healthcare industry

Revenue cycle management is the process of managing the financial aspects of a patient's healthcare journey.

• It involves everything from verifying insurance coverage to submitting claims and collecting payments.

• The goal is to optimize revenue and minimize financial risk for healthcare providers.

• The insurance cycle includes the steps of patient registration, insurance verification, claim submission, claim adjudication, and payment.

• Experience in medical billing, coding, and reim...read more

R1 refers to the first stage of the revenue cycle management process.

• R1 is the initial step in the revenue cycle management process.

• It involves patient registration, insurance verification, and pre-authorization.

• R1RCM is a company that provides revenue cycle management services.

• The 'R' in R1RCM stands for 'revenue'.

Yes, I have experience in data analysis for over 5 years.

• I have worked as a data analyst for 5+ years

• Proficient in using tools like Excel, SQL, and Tableau

• Experience in analyzing large datasets and presenting insights to stakeholders

I can bring my expertise in data analysis and process improvement to help optimize operations at r1rcm.

• Utilize data analytics to identify areas for improvement in revenue cycle management processes

• Implement strategies to streamline workflows and increase efficiency

• Provide recommendations for optimizing revenue capture and reducing denials

• Collaborate with cross-functional teams to implement best practices and drive results

ICD guidelines for diabetes include specific codes for type 1, type 2, and gestational diabetes.

• ICD-10-CM codes for diabetes include E08-E13

• Type 1 diabetes is coded as E10

• Type 2 diabetes is coded as E11

• Gestational diabetes is coded as O24

• ICD guidelines provide specific codes for complications of diabetes as well

Accounts receivable is the money owed to a company by its customers for goods or services provided on credit.

• Accounts receivable represents the amount of money owed to a company by its customers.

• It is considered an asset on the company's balance sheet.

• Companies often offer credit terms to customers, allowing them to pay for goods or services at a later date.

• Accounts receivable is typically collected within a certain time frame, known as the payment terms.

• Examples include invo...read more

Migrating VMware server to Azure involves planning, preparation, and execution of the migration process.

• Assess current VMware environment to determine resources and dependencies

• Create a migration plan outlining steps, timeline, and potential risks

• Prepare Azure environment by setting up necessary resources and configurations

• Use Azure Site Recovery or Azure Migrate tool for migration

• Test the migration process in a non-production environment before executing in production

• Monitor...read more

A customer care executive is a professional who provides assistance and support to customers, ensuring their satisfaction and resolving their issues.

• Customer care executives are responsible for handling customer inquiries, complaints, and feedback.

• They provide information about products or services, answer questions, and address concerns.

• They may assist customers in placing orders, tracking shipments, or processing returns.

• Customer care executives strive to provide excellent ...read more

GAAP are a set of accounting standards and guidelines used in the US to ensure consistency and transparency in financial reporting.

• GAAP are a set of rules and guidelines for accounting in the US

• They ensure consistency and transparency in financial reporting

• GAAP principles cover topics such as revenue recognition, balance sheet classification, and financial statement presentation

• Examples of GAAP principles include the matching principle, materiality principle, and consistency ...read more

The pillars of object oriented programming are encapsulation, inheritance, and polymorphism.

• Encapsulation: Bundling data and methods that operate on the data into a single unit (object).

• Inheritance: Allowing a new class to inherit properties and behavior from an existing class.

• Polymorphism: The ability for objects of different classes to respond to the same message in different ways.

I have automated various tasks in Automation Anywhere including data entry, report generation, and email notifications.

• Automated data entry processes by extracting data from emails and inputting it into designated systems

• Created bots to generate reports based on predefined criteria and schedule them to be sent via email

• Set up notifications to alert users of specific events or errors in the system

Cashposting is the process of recording and reconciling cash transactions in an organization's financial records.

• Cashposting involves documenting and categorizing all incoming and outgoing cash transactions.

• It helps in maintaining accurate financial records and tracking the flow of cash within an organization.

• Cashposting includes activities like recording cash receipts, depositing cash, reconciling bank statements, and updating accounting systems.

• It ensures that cash transact...read more

Interfaces are used to define contracts for classes to implement, while abstract classes can provide partial implementation.

• Interfaces can only have abstract methods and cannot have any implementation, while abstract classes can have both abstract and concrete methods.

• A class can implement multiple interfaces but can only inherit from one abstract class.

• Interfaces are used to achieve multiple inheritance in Java, while abstract classes are used to provide a common base for su...read more

Univariate analysis deals with one variable, bivariate analysis deals with two variables, and multivariate analysis deals with more than two variables.

• Univariate analysis involves examining the distribution of a single variable, such as calculating mean, median, mode, and standard deviation.

• Bivariate analysis involves examining the relationship between two variables, such as correlation and regression analysis.

• Multivariate analysis involves examining the relationship between ...read more

Commands and techniques for migrating taskbots in A360

• Use the Export and Import commands in Automation Anywhere to migrate taskbots

• Ensure all dependencies are included in the migration process

• Test the migrated taskbots thoroughly before deployment

R1 RCM is a leading provider of revenue cycle management services for healthcare organizations.

• R1 RCM helps healthcare providers improve their revenue cycle processes and maximize financial performance.

• They offer services such as coding, billing, collections, and patient registration.

• R1 RCM uses technology and analytics to streamline revenue cycle operations and increase efficiency.

• The company works with hospitals, health systems, and physician groups to optimize revenue and ...read more

Internal auditing is an independent, objective assurance and consulting activity designed to add value and improve an organization's operations.

• Internal auditing involves evaluating and improving the effectiveness of risk management, control, and governance processes within an organization.

• Internal auditors provide recommendations for enhancing internal controls and operational efficiencies.

• They help organizations achieve their objectives by bringing a systematic, disciplined...read more

A normal workday routine involves arriving at work, checking emails, attending meetings, completing tasks, and leaving work.

• Arrive at work on time

• Check emails and respond to urgent ones

• Attend meetings and take notes

• Complete tasks assigned for the day

• Take breaks and lunch as needed

• Leave work at the end of the day

Posting payment is the process of recording and reconciling payments received from patients or insurance companies.

• Payment information is entered into the billing system

• The payment is matched with the corresponding claim or invoice

• Any adjustments or write-offs are applied

• The balance is updated in the patient's account

• Examples include posting co-payments, deductibles, and insurance payments

The suffix "-ectomy" refers to the surgical removal of a body part or organ.

• The suffix "-ectomy" is derived from the Greek word "ektomē", meaning excision or removal.

• Examples include tonsillectomy (removal of the tonsils), appendectomy (removal of the appendix), and mastectomy (removal of the breast).

RCM cycle refers to the process of managing revenue in healthcare organizations.

• RCM stands for Revenue Cycle Management.

• It involves managing the financial aspects of patient care.

• The cycle includes patient registration, insurance verification, charge capture, coding, billing, and collections.

• The goal is to optimize revenue and minimize financial risk.

• RCM is important for healthcare organizations to maintain financial stability and provide quality care.

The correct claim number is the unique identifier assigned to a specific insurance claim.

• The correct claim number is typically provided by the insurance company or healthcare provider.

• It is important to double check the claim number for accuracy to avoid processing delays.

• For example, a correct claim number could be '1234567890'.

Pitch circle is an imaginary circle that passes through the point of contact of two meshing gears.

• It is used to determine the gear ratio and the velocity ratio of the gears.

• It is also used to calculate the center distance between the gears.

• The diameter of the pitch circle is proportional to the number of teeth on the gear.

• The pitch circle is also known as the reference circle or the pitch diameter.

CPT code stands for Current Procedural Terminology code and is used to identify medical procedures and services for billing purposes.

• CPT codes are maintained by the American Medical Association (AMA).

• They are five-digit codes that describe medical procedures and services.

• CPT codes are used by healthcare providers to bill insurance companies and patients.

• Each CPT code has a corresponding fee that is used to determine the cost of the procedure or service.

• Examples of CPT codes i...read more

Customer service involves providing assistance and support to customers before, during, and after a purchase.

• Customer service is all about meeting the needs and expectations of customers.

• It involves actively listening to customers, addressing their concerns, and finding solutions to their problems.

• Providing timely and accurate information, being courteous and empathetic, and going above and beyond to ensure customer satisfaction are key aspects of customer service.

• Examples in...read more

Data warehouse is a centralized repository for storing and analyzing data from various sources to support decision-making processes.

• Data warehouse stores historical data from different sources for analysis

• It is used for reporting, querying, and data mining

• Data is structured in a way that makes it easier to query and analyze

• Examples: Amazon using data warehouse to analyze customer behavior, sales trends

• Data warehouse helps in making strategic decisions based on data analysis

Two stroke and four stroke are types of internal combustion engines used in vehicles and machines.

• Two stroke engines complete a power cycle in two strokes of the piston, while four stroke engines complete it in four strokes.

• Two stroke engines have a simpler design and are lighter, but are less fuel efficient and emit more pollutants.

• Four stroke engines are more complex and heavier, but are more fuel efficient and emit fewer pollutants.

• Examples of vehicles that use two stroke ...read more

Yes, I have worked on escription.

• I have experience using escription software for medical transcription.

• I am familiar with the features and functions of escription.

• I have transcribed various medical reports using escription.

• I am comfortable working with escription and can adapt to any updates or changes.

SAP Automation involves using RPA tools to automate repetitive tasks within SAP systems.

• SAP Automation helps in automating processes like data entry, report generation, and invoice processing within SAP systems.

• RPA tools like UiPath, Automation Anywhere, and Blue Prism can be used for SAP Automation.

• SAP Automation reduces manual errors, improves efficiency, and saves time for employees.

• Automating SAP processes can lead to cost savings and increased productivity for organizati...read more

Chronic kidney disease is a long-term condition where the kidneys are unable to filter blood properly, leading to waste buildup in the body.

• Chronic kidney disease is often caused by conditions like diabetes, high blood pressure, or glomerulonephritis.

• Symptoms may include fatigue, swelling, changes in urination, and high blood pressure.

• Treatment may involve medications, lifestyle changes, and in severe cases, dialysis or kidney transplant.

Medicare is a federal health insurance program for people who are 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease.

• Medicare is divided into different parts: Part A covers hospital stays, Part B covers medical services, Part C is Medicare Advantage, and Part D covers prescription drugs.

• Medicare is funded through payroll taxes, premiums, and federal general revenue.

• Medicare beneficiaries can choose to receive their benefits through ...read more

Medicaid is a government program that provides health coverage to low-income individuals and families.

• Medicaid is jointly funded by the federal government and individual states.

• It covers a wide range of medical services, including doctor visits, hospital stays, prescription drugs, and long-term care.

• Eligibility for Medicaid is based on income and other factors, and varies by state.

• Medicaid is different from Medicare, which is a federal program for older adults and individuals...read more

A modifier is a code used in medical billing to indicate that a service or procedure has been altered in some way.

• Modifiers are two-digit codes that are added to a CPT or HCPCS code to provide additional information about the service or procedure.

• Modifiers can indicate that a service was performed on a different body part, that a service was repeated, or that a service was performed by a different provider.

• Modifiers can also affect the reimbursement rate for a service or proc...read more

RCM stands for Revenue Cycle Management, which is the process of managing the financial aspects of healthcare services.

• RCM involves managing the entire patient journey from registration to payment.

• It includes tasks such as verifying insurance coverage, submitting claims, and collecting payments.

• Effective RCM can improve revenue, reduce denials, and increase patient satisfaction.

• Examples of RCM software include Epic, Cerner, and Allscripts.

Managed care plans are healthcare plans that aim to control costs and improve quality of care.

• Managed care plans negotiate with healthcare providers to offer services at lower costs.

• They often require patients to choose a primary care physician and get referrals for specialist care.

• Examples of managed care plans include HMOs, PPOs, and POS plans.

• These plans may also offer incentives for patients to use preventive care services.

• Managed care plans have been criticized for limit...read more

MDM table stands for Master Data Management table, which is used to store and manage critical data about an organization's key entities.

• MDM table is used to store and manage master data, which includes information about customers, products, employees, etc.

• It helps in ensuring data consistency and accuracy across different systems and applications.

• MDM tables are often used in data warehousing and business intelligence projects.

• Example: An MDM table for customers may store deta...read more

An aneurysm is a bulge or ballooning in a blood vessel caused by a weakening in the vessel wall.

• An aneurysm can occur in any blood vessel in the body, but most commonly in the aorta (aortic aneurysm) or the brain (cerebral aneurysm).

• Risk factors for developing an aneurysm include high blood pressure, smoking, and a family history of aneurysms.

• Symptoms of an aneurysm can vary depending on the location and size, but may include pain, pulsating sensation, or neurological symptom...read more

Amputation is the surgical removal of a limb or part of a limb.

• Amputation is typically done as a last resort to remove a diseased or damaged limb that is causing pain or infection.

• Common reasons for amputation include severe trauma, cancer, diabetes complications, and vascular disease.

• Types of amputation include above-the-knee, below-the-knee, arm, and finger/toe amputations.

• Rehabilitation and prosthetic devices are often used to help amputees regain function and mobility.

EOB and ERA are two types of payment remittance advice used in medical billing.

• EOB stands for Explanation of Benefits and is a paper document sent by insurance companies to patients explaining what medical treatments and services were paid for and what the patient owes.

• ERA stands for Electronic Remittance Advice and is an electronic version of the EOB that is sent directly to healthcare providers.

• Both EOB and ERA provide important information about payments made by insurance ...read more

Chargentry is the process of entering charges for medical services rendered by healthcare providers.

• Chargentry involves accurately recording the services provided by healthcare providers and the corresponding charges.

• It is an important step in the medical billing process as it ensures that healthcare providers are reimbursed for the services they provide.

• Chargentry may involve reviewing medical records, verifying insurance coverage, and ensuring that charges are in compliance...read more

Automation is the use of technology to perform tasks without human intervention.

• Automation can increase efficiency and accuracy in various industries.

• Examples of automation include robotic process automation, chatbots, and self-driving cars.

• Automation can also lead to job displacement and require new skill sets for workers.

• Continuous monitoring and improvement are necessary for successful automation implementation.

Indexes are data structures that improve the speed of data retrieval operations on a database table.

• Indexes are created on columns in a database table to quickly retrieve rows matching a certain condition.

• They can be unique, allowing only unique values to be stored in the indexed column.

• Examples include primary keys, foreign keys, and indexes on frequently queried columns.

Medical coding is the process of converting healthcare diagnoses, procedures, medical services, and equipment into universal alphanumeric codes.

• Medical coding is essential for billing and reimbursement in healthcare.

• Codes are used to accurately describe diagnoses, treatments, and procedures.

• ICD-10, CPT, and HCPCS are common code sets used in medical coding.

• Accurate coding ensures proper documentation and communication between healthcare providers and insurance companies.

Cyber security is the practice of protecting systems, networks, and data from digital attacks.

• Cyber security involves implementing measures to prevent unauthorized access to information.

• It includes technologies, processes, and practices designed to protect networks, devices, and data from cyber threats.

• Examples of cyber security measures include firewalls, antivirus software, encryption, and multi-factor authentication.

Load balancer distributes traffic across multiple servers, while app gateway provides secure access to applications.

• Load balancer distributes incoming network traffic across multiple servers to ensure no single server is overwhelmed.

• App gateway acts as a secure entry point for accessing applications, providing features like SSL termination, WAF, and authentication.

• Load balancer operates at layer 4 (TCP/UDP) or layer 7 (HTTP/HTTPS), while app gateway operates at layer 7.

• Exampl...read more

Providing pay slips for the last three months to demonstrate income stability and consistency.

• Ensure pay slips are accurate and up to date

• Highlight any bonuses or additional income

• Explain any fluctuations in income if necessary

R1RCM is a leading provider of technology-enabled revenue cycle management services for healthcare providers.

• R1RCM helps healthcare providers optimize their revenue cycle processes to improve financial performance.

• They offer services such as coding, billing, collections, and patient registration.

• R1RCM uses advanced technology and analytics to streamline revenue cycle operations.

• The company serves a wide range of healthcare organizations, including hospitals, physician practic...read more

Diagnosis codes are alphanumeric codes used to identify specific diseases, disorders, symptoms, or conditions in medical billing and coding.

• Diagnosis codes are used in medical billing to communicate the reason for a patient's visit or treatment.

• They are typically found on medical claims and are used by healthcare providers to justify the services provided.

• Diagnosis codes are standardized and follow specific code sets such as ICD-10-CM (International Classification of Diseases...read more

My vision with R1 is to streamline operations, improve efficiency, and enhance patient experience.

• Implementing process improvements to reduce wait times and increase patient satisfaction

• Utilizing data analytics to identify areas for improvement and optimize resource allocation

• Fostering a culture of continuous improvement and employee engagement

• Collaborating with cross-functional teams to drive innovation and achieve organizational goals

The healthcare process involves the delivery of medical services to individuals in order to diagnose, treat, and prevent illnesses.

• Patient seeks medical care for symptoms or preventive services

• Healthcare provider evaluates patient's condition through exams, tests, and consultations

• Provider diagnoses the illness or condition and develops a treatment plan

• Treatment may include medications, surgeries, therapies, or lifestyle changes

• Follow-up care and monitoring to assess the effe...read more

Quality Analyst ensures products meet standards by testing, analyzing, and identifying defects.

• Conducting tests to identify defects in products

• Analyzing test results and providing feedback to developers

• Creating and implementing quality assurance processes

• Collaborating with cross-functional teams to improve product quality

• Documenting and reporting issues for resolution

Coding guidelines are important for accurate and consistent medical coding.

• Coding guidelines provide instructions on how to properly assign codes for diagnoses and procedures.

• They help ensure accurate and consistent coding across different healthcare settings.

• Guidelines are updated regularly to reflect changes in medical terminology and coding practices.

• Examples of coding guidelines include the ICD-10-CM Official Guidelines for Coding and Reporting and the CPT Assistant newsl...read more

Non covered denial refers to a claim denial by an insurance company for services that are not covered under the policy.

• Non covered denial occurs when the insurance company determines that the service or treatment is not included in the policy benefits.

• This type of denial can result in the patient being responsible for the full cost of the service.

• Examples include cosmetic procedures, experimental treatments, or services not deemed medically necessary.

CTC stands for Cost to Company and refers to the total salary package of an employee including all benefits and perks.

• CTC includes basic salary, allowances, bonuses, and other benefits such as health insurance, retirement plans, etc.

• Employers use CTC to calculate the total cost of hiring an employee.

• CTC is different from take-home salary as it includes deductions such as taxes and other contributions.

• For example, if an employee's CTC is $50,000 per year, their take-home salar...read more

Medical billing has evolved from manual paper-based processes to electronic systems.

• Initially, medical billing was done manually using paper-based processes.

• With the advent of computers, billing software was developed to automate the process.

• Electronic medical records (EMRs) have further streamlined the billing process.

• Medical billing now involves coding diagnoses and procedures using standardized code sets such as ICD-10 and CPT.

• Insurance companies and government programs su...read more

I am not able to relocate at this time due to personal commitments.

• Explain that you are unable to relocate due to personal reasons

• Assure that you are committed to the job and willing to work remotely if possible

• Discuss any potential flexibility in working arrangements