[15h Left] AR Callers & Denial Management, EVBV, Authorization Specialists - (Medical Billing)

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.
• Meet the productivity and quality target on a daily / monthly basis.
• Upskill by learning new / additional skills and enhancing competencies. Active participation in all process / client-specific training and refresher training.

Requirements :

Key Responsibilities for EVBV :

Requirements :

1 to 3 years of experience in US Healthcare RCM, specifically in Eligibility & Benefits Verification.

Key Responsibilities for Authorization :

Requirements :