Medical Claims Specialist

6 days ago

Kottayam, Kerala, India beBeeDenial Full time ₹ 43,20,000 - ₹ 61,20,000
Job Role Overview

As a professional in medical claims and reimbursement, you will be responsible for contacting insurance companies and patients to follow up on outstanding medical claims and ensure accurate billing.

This process involves navigating complex rules, regulations, and coding standards, and professionals often play a critical role in denial management.

Key Responsibilities:
  • Claims Resolution:

  • Initiate calls to insurance companies to inquire about the status of denied claims, ensuring all interactions are documented thoroughly.

  • Claim Re-submittal:

  • Involved in re-submitting claims with corrected information or appealing denials when necessary.

  • Stakeholder Communication:

  • Communicate with patients and internal stakeholders about denial statuses and resolution efforts, providing clear explanations and ensuring understanding of the process.

Importance of Denial Management:
  • Revenue Growth:

  • Effective denial management, including claims handling, helps healthcare providers recover more revenue from claims by ensuring accurate billing.

  • Streamlined Operations:

  • Speeding up the revenue cycle through denial management can improve cash flow by minimizing delays and processing times.

  • Enhanced Patient Relationships:

  • Professionals often communicate with patients to explain denial reasons, provide clarification, and ensure they understand the process, thereby enhancing patient relationships and satisfaction.

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