Summary of the role
The purpose of this position is to ensure accurate and timely management of medical claims by handling insurance follow-ups, resolving denials, and providing actionable insights that support process improvements. This role upholds compliance with healthcare regulations while maintaining clear communication, accurate documentation, and efficient claims resolution to optimize revenue cycle performance.
List of Functional Responsibilitie
sOutbound Calling
- :Make outbound calls to insurance companies and payors to collect essential information, including claim statuses, denial reasons, and any additional relevant details
- .Conduct all calls in full compliance with the Client's guidelines and applicable healthcare regulations
- .Maintain professionalism and ensure clear communication during each call
.Data Categorization and Labeling
- :Accurately record, categorize, and label calls or information gathered using the taxonomy and definitions provided by the client
- .Ensure all claim statuses and call outcomes are properly labeled for consistency in reporting and easy analysis
- .Deliver categorized data in periodic reports or through the portal developed by client, following the requested format and frequency
.Call Transcript Analysis
- :Analyze recorded call transcripts to extract actionable insights, identifying trends, recurring denial reasons, and other patterns
- .Compile findings into periodic reports, providing valuable information to the Client to support process improvements and optimize workflows
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List of soft skills requir
- edStrong English proficiency, both verbal and writte
- n.Excellent communication skills with the ability to make outbound calls to insurance companies and payor
- s.Detail-oriented and able to maintain accurate record
- s.Ability to work independently while adhering to internal guidelines and procedure
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