1. Denial Management:

· Analyze and resolve claim denials promptly, identifying root causes and implementing corrective actions.
· Collaborate with billing and coding teams to prevent recurring denials and improve overall claims acceptance rates.

2. Appeals and Resubmissions:

· Prepare and submit appeals for denied claims, providing necessary documentation to support claim reconsideration.
· Monitor the status of appealed claims and take appropriate actions to expedite resolution.

3. Patient Collections:

· Engage in insurance collections activities, including making follow-up calls, and setting up payment plans.
· Provide clear communication to address inquiries regarding billing and outstanding balances.

4. Analysis:

· Analysis of generated reports on denial trends, collection activities, and outstanding balances, providing insights for process improvement.

5. Collaboration with Internal Teams:

· Work closely with billing, accounts receivable, and customer service teams to ensure a cohesive and effective approach to denial management and patient collections.

Qualifications:

· Excellent attention to detail and accuracy in data entry and documentation.
· Strong analytical and problem-solving skills.
· Effective communication skills, both verbal and written.
· Ability to work independently and collaboratively within a team.