Posted Apr 12, 2024 552 views Report Job
Responsibilities:
- Claim Processing: Accurately review and process medical claims according to established guidelines and procedures.
- Coding Verification: Ensure correct coding of diagnoses and procedures for claims submission.
- Claim Submission: Submit claims electronically or by paper to various health insurance companies within specified timelines.
- Follow-up on Claims: Monitor the status of submitted claims and follow up with insurance companies to resolve any issues or discrepancies.
- Payment Posting: Record and reconcile payments received from insurance companies with the billed amounts.
- Denial Management: Investigate and resolve claim denials by providing additional information or appealing the decision when necessary.
- Documentation: Maintain accurate and detailed records of all claim processing activities.
- Compliance: Adhere to healthcare regulations, insurance guidelines, and billing best practices to ensure compliance.
- Communication: Collaborate with internal teams, healthcare providers, and insurance representatives to resolve claim-related queries.
Qualifications:
- Bachelor's degree.
- Proven experience working in medical billing or claims processing role.
- Strong understanding of medical billing processes, including CPT and ICD coding.
- Proficiency in using billing software and electronic health record (EHR) systems.
- Excellent attention to detail and accuracy in data entry and claim processing.
- Knowledge of healthcare insurance plans, policies, and procedures.
- Ability to work independently and efficiently in a fast-paced environment.
- Effective communication skills to interact with internal and external stakeholders.
- Familiarity with HIPAA regulations and patient confidentiality requirements.
Job Details
Prima Systems
Prima Systems enables its clients over the whole Enterprise Technology to stack with separated industry arrangements. We modernize Business Process Outsourcing and make everything secure, adaptable and coordinated across open, private and half mists. Partnership is at our core. Our client relationships are about more than just the work we do, they are a huge part of who we are. At BPO Bench, we consider the success of our clients as a barometer of how successful we are. The Enterprise Technology Stack incorporates IT Outsourcing, Cloud and Security, Applications, Analytics and Engineering. We join long periods of experience running crucial frameworks with the most recent advanced developments to convey better business results and new degrees of execution, intensity and encounters for our clients and their partners. Prima Systems puts resources into three key drivers of development: People, Customers and Operational Execution. Our broad network helps drive coordinated effort and influence innovation freedom.
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