Claim Resolutions Professional

1 day ago

Nashik, Maharashtra, India beBeeReimbursement Full time ₹ 8,74,326 - ₹ 14,52,345

Outsourcing Specialist

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The primary responsibility of an Insurance Claim Resolutions Specialist is to contact insurance companies and patients to follow up on outstanding medical claims, ensuring accurate reimbursement.

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  • Responsibilities include initiating calls to insurance companies to inquire about claim statuses, documenting interactions and follow-up actions, re-submitting claims with corrected information or appealing denials, and communicating denial statuses and resolution efforts to patients and internal stakeholders.\
  • In this critical role, effective communication and negotiation skills are essential for resolving disputes and achieving successful claim resolutions.\
  • Additionally, thorough records of all interactions and follow-up actions must be maintained.\
  • By playing a key part in the revenue cycle, Insurance Claim Resolutions Specialists contribute significantly to healthcare providers' financial performance.\
  • Speeding up the revenue cycle through denial management and AR calling can improve cash flow, which has a positive impact on healthcare providers' operations and overall performance.\
  • Effective denial management, including AR calling, helps healthcare providers recover more revenue from claims.\
  • Improved patient relationships are also a result of this role, as AR callers communicate with patients to explain denial reasons and ensure they understand the process.\
  • Denial Management and Healthcare Providers have a strong connection, as the former directly affects the latter's revenue and financial performance.\

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