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4 days ago
We are seeking a skilled US Healthcare Follow-Up Specialist to join our team. As a key member of our operations, you will be responsible for making outbound calls to US insurance companies to resolve unpaid or denied claims. Your goal will be to analyze claim status, reason for denial, and take corrective actions to ensure timely resolution.
- Key Responsibilities:
- Making outbound calls to US insurance companies to resolve unpaid or denied claims.
- Analyzing claim status, reason for denial, and taking corrective actions.
- Documenting call activity and resolution in the billing system.
- FOLLOWING up consistently until the claim is resolved.
Pre-Authorization and Eligibility Verification Expertise:
- Initiating and obtaining prior authorization from payers for scheduled medical services/procedures.
- Contacting insurance carriers via portals or phone.
- Coordinating with providers and patients to collect required clinical documents.
- Recording auth number, validity, and status for billing.
Eligibility Criteria:
- Candidates should hold any graduate degree (Life Sciences, Paramedical, Commerce, Arts, etc.).
- A minimum of 0–3 years of experience in US Healthcare RCM is preferred.
- The ideal candidate will possess excellent spoken and written English communication skills.
- Familiarity with US health insurance terms (PPO, HMO, Medicare, Medicaid) is essential.
- BASIC knowledge of RCM cycle, CPT/ICD codes, and payer portals is a plus.
- A typing speed of 30–35 WPM is required for EVBV/Pre-auth roles.
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