Issue Resolution Analyst Interview Questions and Answers

Contacts between insurances and providers involve communication regarding coverage, claims, and billing.

• Insurances and providers communicate to verify coverage for services

• Providers submit claims to insurances for reimbursement

• Insurances and providers discuss billing and payment issues

• Contracts between insurances and providers outline terms of reimbursement

Denial management of claims involves identifying reasons for claim denials and taking steps to resolve them.

• Identify common reasons for claim denials such as incorrect patient information, lack of pre-authorization, or coding errors

• Implement processes to prevent denials, such as verifying patient information before submitting claims

• Work with payers to understand denial reasons and appeal denied claims with supporting documentation

• Track denial trends to identify areas for impr...read more