Medical Claims Analyst
Med-Metrix
Date: 2 weeks ago
City: Chennai, Tamil Nadu
Contract type: Full time
Job Purpose
The Medical Claims Analyst is responsible for collections, account follow up, billing and allowance posting for the accounts assigned to them.
Duties And Responsibilities
The Medical Claims Analyst is responsible for collections, account follow up, billing and allowance posting for the accounts assigned to them.
Duties And Responsibilities
- Follow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or websites
- Meets and maintains daily productivity/quality standards established in departmental policies
- Uses the workflow system, client host system and other tools available to them to collect payments and resolve accounts
- Adheres to the policies and procedures established for the client/team
- Knowledge of timely filing deadlines for each designated payer
- Performs research regarding payer specific billing guidelines as needed
- Ability to analyze, identify and resolve issues causing payer payment delays
- Ability to analyze, identify and trend claims issues to proactively reduce denials
- Communicates to management any issues and/or trends identified
- Initiate appeals when necessary
- Ability to identify and correct medical billing errors
- Send appropriate appeals, accurate requesting information, supporting documentation, and effective communication to complete recovery process
- Understanding of under or over payments and credit balance processes
- Assist with special A/R projects as needed. Analytical skills and the ability to communicate results are required
- Act cooperatively and courteously with patients, visitors, co-workers, management and clients
- Work independently from assigned work queues
- Maintain confidentiality at all times
- Maintain a professional attitude
- Other duties as assigned by the management team
- Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
- Understand and comply with Information Security and HIPAA policies and procedures at all times
- Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties
- Completed at least High School education
- Minimum 1 year of Healthcare Account Receivable/Collections in a BPO setting or environment (claims payments processing, claims status and tracking, Medical Billing, AR Follow ups, Denials and Appeals-outbound healthcare providers)
- Experienced on medical billing/ AR Collections
- Background in calling insurance (Payer) to verify claim status and payment dispute
- Strong interpersonal skills, ability to communicate well at all levels of the organization
- Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses
- High level of integrity and dependability with a strong sense of urgency and results oriented
- Excellent written and verbal communication skills required
- Gracious and welcoming personality for customer service interaction
- Must be amenable to work night shifts
- Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.
- Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress.
- Work Environment: The noise level in the work environment is usually minimal.
How to apply
To apply for this job you need to authorize on our website. If you don't have an account yet, please register.
Post a resumeSimilar jobs
Applications Devt Associate
UPS,
Chennai, Tamil Nadu
4 days ago
Before you apply to a job, select your language preference from the options available at the top right of this page.Explore your next opportunity at a Fortune Global 500 organization. Envision innovative possibilities, experience our rewarding culture, and work with talented teams that help you become better every day. We know what it takes to lead UPS into tomorrow—people with...
Specialist WRB
Standard Chartered India,
Chennai, Tamil Nadu
1 week ago
Key ResponsibilitiesStrategyFocus on Process Efficiency and align to the Record to Close (R2R) processes Ability to connect to the big picture Ensure to achieve efficiency in processes, quality and cost.Business Effective stakeholder management for respective processes across geographiesProcesses Ensuring that continuous efficiency improvement in R2R activities and an established process exists to constantly identify and implement improvement opportunities Bring Process...
Recruiter 2
U.S. Bank,
Chennai, Tamil Nadu
1 week ago
At U.S. Bancorp India, we’re on a journey to do our best. We believe it takes all of us to bring our shared ambition to life, and each person is unique in their potential. A career with U.S. Bancorp India gives you a wide, ever-growing range of opportunities to discover what makes you thrive at every stage of your career....
