Senior AR Analyst Interview Questions and Answers

Explaining 5 denials and deep action for Senior AR Analyst position

• Denial 1: Claim denied due to incorrect patient information. Action: Verify patient information and resubmit claim

• Denial 2: Claim denied due to lack of medical necessity. Action: Provide additional documentation to support medical necessity

• Denial 3: Claim denied due to duplicate billing. Action: Investigate and correct any duplicate billing errors

• Denial 4: Claim denied due to timely filing limit exceeded. Acti...read more

Explanation of prior auth and referral difference and 5 major denials

• Prior authorization is a process of obtaining approval from insurance for a specific medication or procedure before it is performed

• Referral is a process of obtaining a recommendation from a primary care physician to see a specialist

• Major denials include: incorrect patient information, lack of medical necessity, non-covered service, duplicate claim, and timely filing

• Incorrect patient information denial occurs...read more

Aging bucket is a method to categorize outstanding invoices based on their due dates.

• Create categories based on the number of days past due, such as 0-30 days, 31-60 days, 61-90 days, and over 90 days.

• Prioritize collections efforts on the oldest invoices in each category.

• Regularly review and update the aging bucket to ensure accuracy.

• Use aging bucket reports to identify trends and potential issues with customer payments.

• Communicate with customers to resolve outstanding invoic...read more

Inclusive denial can be resolved by identifying the root cause, providing additional documentation or clarification, and appealing the denial if necessary.

• Identify the reason for the denial by reviewing the denial letter or contacting the payer.

• Gather any additional documentation or information that supports the claim and addresses the reason for denial.

• Submit an appeal with the necessary documentation and a clear explanation of why the denial should be overturned.

• Follow up w...read more

HMO stands for Health Maintenance Organization.

• HMO is a type of health insurance plan that typically requires you to choose a primary care physician who will coordinate your care.

• HMO plans usually have lower out-of-pocket costs but limit your choice of healthcare providers.

• HMO plans are popular among employers and individuals who want predictable healthcare costs.

• Examples of HMO plans include Kaiser Permanente and Aetna HMO.