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The Role
Perform AR follow-up and denial management for physician and hospital claims by contacting payers, investigating denials, analyzing EOBs, filing appeals, updating billing systems, collaborating with coding teams, and recommending corrective actions to maximize reimbursements while meeting productivity and quality targets.
Summary Generated by Built In
Roles & Responsibilities
- Perform AR follow-up on outstanding insurance claims and denied claims.
- Contact insurance companies via calls, IVR, or web portals to obtain claim status.
- Investigate and resolve claim denials, underpayments, and payment delays.
- Analyze EOBs (Explanation of Benefits) and determine appropriate actions.
- Work on denial management and appeals to maximize reimbursements.
- Document call outcomes and update claim status accurately in the billing system.
- Identify trends in denials and recommend corrective actions.
- Follow up on pending claims and ensure timely resolution.
- Maintain productivity and quality standards as defined by the organization.
- Collaborate with billing and coding teams to resolve claim-related issues.
- Knowledge of US Healthcare and Medical Billing processes.
- Experience in AR Follow-up and Denial Management.
- Understanding of Medicare, Medicaid, and Commercial Insurance policies.
- Strong verbal and written communication skills.
- Good analytical and problem-solving abilities.
- Ability to work with billing software and MS Excel.
- Ability to meet productivity and quality targets
Skills Required
- Knowledge of US Healthcare and Medical Billing processes.
- Experience in AR Follow-up and Denial Management.
- Understanding of Medicare, Medicaid, and Commercial Insurance policies.
- Strong verbal and written communication skills.
- Good analytical and problem-solving abilities.
- Ability to work with billing software and MS Excel.
- Ability to meet productivity and quality targets.
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The Company
What We Do
GetixHealth provides hospitals, clinics, university medical centers, and other healthcare facilities across the United States with comprehensive revenue cycle management (RCM) services. Our services are customized to the needs of our client and can either include all facets of the front and back office revenue cycle or a mixture of these services, including but not limited to: medical coding and billing, claims management, insurance eligibility services, medicaid/medicare specialized services, and self pay and bad debt collections.
