L2 associate_medical

Responsible for Posting: Medical Charges, Payments, Journal Entries. Entries to be done in Accurate & Timely Manner. Process Claim Denials. Verify Correct Insurance Filing information on behalf of the Client and Patient. Ability to Prioritize and Manage work queue. Ability to work independently as well as in a Team Environment. Strong Verbal and Written Communication Skills. Strong Analytical and Problem-solving Skills

Using Coded Data to produce & submit Claims to Insurance Companies. Working directly with the Insurance Company, Healthcare Provider & Patient. Reviewing and Appealing Unpaid and Denied Claims. Answering Patients' Billing Questions.

Initiate telephone calls to in requesting status of claims in queue. Contact insurance companies for further explanation of denials and underpayments. Take appropriate action on claims to guarantee resolution. Ensure accurate and timely follow up where required. Review denials with Billing Account Liaison to determine necessary steps for claim review. Document actions taken in claims billing summary notes.

Responsible for calling Insurance companies (in the US) on behalf of doctors/physicians and follow up on outstanding Accounts Receivable. Good understanding of Accounts Receivable. Calling Insurance Companies to follow up on Claims filed, to expedite payment. Should possess knowledge in AR analysis, AR calling and denial management. Undertakes denial follow-up and appeals work wherever required. Reviewing, appealing and rejecting unpaid and denied claims. Documents and takes appropriate action of all claims which has been analyzed and followed-up in the clients software. Verifying patients insurance coverage Answering patient billing questions. Should possess knowledge in eligibility and verification calls (EV calls). Experience indirectly working with insurance companies. Analyses outstanding claims and initiates collection efforts as per the aging report.

Should have 1 to 2 years of experience in Payment posting. To understand Medical billing concepts and terminologies to post payments in the billing software. Exposure to Payment posting and denials. Downloading EOBs from the website, Analyzing and posting the Bank statement vs Reconciliation log missing payments. Apply for insurance payments according to specific dates and procedures according to the EOB. Having basic knowledge of insurances to identify Par /Non-Par/ WC / MVA/ etc. Review and assess adjudicated claims for timely and proper payment of outstanding balances. Verify the validity of account balance by researching, reviewing and ensuring accuracy of payment and adjustment posting. Review and interpret Explanation of Benefits (EOB) for denials and underpayment of codes. Responsible for achieving the team s performance standards (KPIs and SLAs).