The Role
Manage accounts receivable follow-up and denial management throughout the medical billing revenue cycle. Investigate claim rejections, review claim statuses, and contact insurance companies regarding unpaid, underpaid, denied, and pending claims. Resolve issues through payer portals while applying payer guidelines, reimbursement policies, and healthcare regulations. The role requires knowledge of commercial insurers and strong analytical, problem-solving, verbal, and written communication skills.
Summary Generated by Built In
Candidate
with a strong understanding of the RCM cycle. The candidate should have
hands-on experience in the following areas:
- Hands-on experience in AR follow-up and denial
management.
- Good understanding of the Medical Billing Revenue
Cycle.
- Analyse and resolve rejections and payer portals.
- Follow up with insurance companies on unpaid,
underpaid, denied, and pending claims.
- Review claim status and take appropriate actions to
secure payment.
- Maintain knowledge of payer guidelines, reimbursement
policies, and healthcare regulations.
- Knowledge of insurance payers such as BCBS, Cigna,
Aetna, UnitedHealthcare, and commercial payers.
- Strong analytical and problem-solving skills.
- Excellent verbal and written communication skills.
Skills Required
- Hands-on experience in accounts receivable follow-up and denial management
- Strong understanding of the medical billing revenue cycle
- Ability to analyze and resolve claim rejections using payer portals
- Experience following up with insurance companies on unpaid, underpaid, denied, and pending claims
- Ability to review claim status and take appropriate actions to secure payment
- Knowledge of payer guidelines, reimbursement policies, and healthcare regulations
- Knowledge of BCBS, Cigna, Aetna, UnitedHealthcare, and commercial payers
- Strong analytical and problem-solving skills
- Excellent verbal and written communication skills
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The Company
What We Do
Calpion is an information technology company specializing in application maintenance and testing services.
