Call Payer (Insurance) to resolve claims (denial/non-denial) after review from PMS, internal system & process toward resolution (Payment,
Adjustment & self-pay).
Identify potential process improvements, trends, issues and escalate to Supervisor through calling.
Follow the Workflow documentation like SOP’s Update tracker, Issue Log and Trend logs.
Be part of all the training session to gain knowledge towards RCM.
Resolve complex patient account issues requiring investigation of system timeline comments, payer reimbursements and account
Identify the accounts which does not require calling and can be fixed by Analyst to resolve
Logical thinking to identify the trends, resolve accounts for an error free account
Identify payer issues and leads special projects to aggregate claim data for payer reprocessing and escalate complex payer issues to the
lead billing specialist as necessary.
ICT Academy is an initiative of the Government of India in collaboration with the state Governments and Industries. ICT Academy is a not-for-profit society, the first of its kind pioneer venture under the Public-Private-Partnership (PPP) model that endeavors to train the higher education teachers and students thereby exercises on developing the next generation teachers and industry ready students.
ICT Academy was started to meet the skill requirements of the industry and generate more employment especially in tier 2 and 3 towns, the rural parts of the country. The organization was formed with representations from the State Government of Tamil Nadu, leading companies in the ICT industry and National Association of Software Services Companies (NASSCOM) in India.