Contact insurance payers to address claims (both denied and non-denied) after reviewing information from PMS and internal systems, aiming for resolution through payment, adjustments, or self-pay.
Recognize and suggest process improvements, identify trends and issues, and escalate them to a Supervisor as needed.
Adhere to workflow documentation, including updating trackers, issue logs, and trend logs according to standard operating procedures (SOPs).
Participate in all training sessions to enhance understanding of Revenue Cycle Management (RCM).
Resolve intricate patient account problems by investigating system timeline comments, payer reimbursements, and account transactions.
Determine which accounts can be resolved by Analysts without requiring additional calls.
Utilize logical thinking to spot trends and ensure accurate resolution of accounts.
Identify payer-related issues, lead special projects to compile claim data for reprocessing, and escalate complex payer issues to the lead billing specialist when necessary.
Requirements
Qualification:
Bachelors degree in Accounting, Finance, Business Administration, or a related field preferred.
Prior experience in accounts receivable or similar roles is advantageous.
Essential for accurate financial transaction processing.
Proficiency in accounting software and Microsoft Office Suite.
Strong verbal and written skills needed for effective interactions.
Ability to analyse data and resolve billing discrepancies efficiently.
Benefits
What We Offer :
Competitive salary and comprehensive benefits package.
Opportunities for professional growth and career development.
A dynamic and collaborative work environment.
Flexible work arrangements to support work-life balance.