About this role
To ensure that denied, rejected, or underpaid insurance claims are corrected and resubmitted accurately and promptly to maximize reimbursement for healthcare services
The post holder will:
• Analyze the rejections
• Clarifying the Rejection queries to the Insurance Company
• Doing Resubmission production for assigned facility with quality.
• Sharing rejection feedback to the Submission team
• Sharing rejection feedback to the Approval team
• Sharing rejection feedback to the reception team.
• Facilities doubt clearing (Coding, insurance Queries)
• Monthly team meeting in sharing the ideas regarding insurance rejection.
• Sharing rejection updates to medical auditor to share with respective doctor.
• Supporting submission team for their queries
• Providing justification for reconciliation claims.
• College Diploma - Any discipline or related fields.
• Coding Certification, CPC – Certified Professional Coder (AAPC)
Proficiency in:
• ICD-10-CM (diagnosis codes)
• CPT (procedure codes)
HCPCS Level II (supplies, equipment, services)