Job Description
Key Responsibilities for AR:
- Review account thoroughly, including any prior comments on the account, EOBs / ERAs / Correspondence, and perform pre-resolution analysis.
- Understand the reason for rejection, denials, or no status from the payer.
- Work on the resolution of the claim by performing follow-up with the payer using the most optimal method, i.e., calling, IVR, web, or email.
- Take appropriate action to move the account towards resolution, including rebilling the claim, sending claims for reprocessing, reconsideration, redetermination, appeal (portal/web, fax, mail), verifying eligibility and benefits, and managing management hand-off with the client and internal teams.
- Documentation of all the actions on the practice management system and workflow management system, and maintain an audit trail.
- Ensure adherence to Standard Operating Procedures and compliance.
- Highlight any global trend/pattern and issue escalation with the leadership team.
- M...
- Review account thoroughly, including any prior comments on the account, EOBs / ERAs / Correspondence, and perform pre-resolution analysis.
- Understand the reason for rejection, denials, or no status from the payer.
- Work on the resolution of the claim by performing follow-up with the payer using the most optimal method, i.e., calling, IVR, web, or email.
- Take appropriate action to move the account towards resolution, including rebilling the claim, sending claims for reprocessing, reconsideration, redetermination, appeal (portal/web, fax, mail), verifying eligibility and benefits, and managing management hand-off with the client and internal teams.
- Documentation of all the actions on the practice management system and workflow management system, and maintain an audit trail.
- Ensure adherence to Standard Operating Procedures and compliance.
- Highlight any global trend/pattern and issue escalation with the leadership team.
- M...
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