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Collections – Insurance Follow up

Job FunctionCollections – Insurance Follow up
General descriptionThis function is very critical to optimise client revenue recovery and increase cash flow. It is a process where unpaid/denied claims are re-worked and corrected to receive the entitled reimbursement from the insurance companies. It takes articulate professionals to communicate with insurance companies to settle disputed claims.
LevelIndividual contributor
Experience Range1-6 years
CompensationUpto 42K INR monthly, subject to years of experince and level of exposure
Job TimingPST shift equivalent to 05:30 PM to 03:00 AM IST
Duties & Responsibilities•  Checking denials from EOBs, ERAs by calling the Insurance Companies
•  Getting the specification of denials from the insurance Company.
•   Reprocessing the claim over the phone or reopening the claims on the online portals.
•   Filing an appeal to the insurance companies with the required information •             Checking status of the appeal filed and reprocessed claims through IVR, Calls and online payer’s portal •   Refilling corrected claims with coding/demographic/authorization/referral corrections.
•   Disputing with the insurance companies on incorrect denials.
•   Working on FTH (Fix-The-Hole) to prevent future denials
•   Tasking to the clients and other teams for required information
•   Preparing Trending Analysis on the denials and escalating to Supervisors
•   Finding updates from payers via call or online for billing related information and sharing with the concern team/department to prevent denials.
•   Responsible for updating any internal databases, electronically storing and organizing patients’ records, billing details, and registration forms.
Education+2 or Graduate in any stream
Training/Work Experience Collections – Insurance follow up and/or 1 year of industry experience in the relevant function
Other Specifications•  Good English communication (reading, writing, listening, speaking)
•  Understanding of US healthcare, HIPAA
•  Good at MS Office
•  Experience in using RCM Software
•  Capable of task execution based on work instructions
Job Type: Full Time
Job Category: Operations
Job Location: Mumbai IND

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