Essential Duties and Responsibilities

• Obtaining referrals and pre-authorizations as required for procedures.
• Checking eligibility and benefits verification for treatments, hospitalizations, and procedures.
• Reviewing patient bills for accuracy and completeness and obtaining any missing information.
• Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing.
• Following up on unpaid claims within the standard billing cycle timeframe.
• Checking each insurance payment for accuracy and compliance with contract discounts. Calling insurance companies regarding any discrepancy in payments if necessary.
• Identifying and billing secondary or tertiary insurances.
• Reviewing accounts for insurance of patient follow-up.
• Researching and appealing denied claims.
• Answering all patient or insurance telephone inquiries pertaining to assigned accounts.
• Setting up patient payment plans and work collection accounts.
• Updating billing software with rate changes.
• Updating cash spreadsheets and running collection reports. Knowledge, Skills, and Abilities
• Proficiency in the following areas is preferred:
• Knowledge of insurance guidelines, including HMO/PPO, Medicare, Medicaid, and other payer requirements and systems.
• Competent use of computer systems, software, and ten key calculators.
• Familiarity with CPT and ICD-10 Coding.
• Effective communication abilities for phone contacts with insurance payers to resolve issues.
• Customer service for interacting with patients about medical claims and payments, including communicating with patients and family members of diverse ages and backgrounds.
• Ability to work well in a team environment. Being able to triage priorities, delegate tasks if needed, and handle conflict in a reasonable fashion.
• Problem-solving skills to research and resolve discrepancies, denials, appeals, and collections.
• A calm manner and patience worked with patients or insurers during this process.
• Knowledge of accounting and bookkeeping procedures.
• Knowledge of medical terminology likely to be encountered in medical claims.
• Maintaining patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
• Ability to multitask

Interested candidates can share your updated resumes with hr@esntechnologies.co.in along with following mandatory details…

• Relevant Experience:
• Current & Expected CTC:
• Notice period:
• Reason for job change:

Posted By
Human Resources ESN Technologies (India) Pvt. Ltd.