Rejections Specialist
Ventra · Chennai · onsite · Posted 49d ago
Undisclosed1–6 yrsfulltimeSourced from
About a minute. You'll make an account on the way through.
About this role
Overview
- The Rejections Specialist is primarily responsible for analyzing collections, resolving non-payables, and handling bill inquiries for more complex issues. Specialists are responsible for insurance payer follow-up ensuring claims are paid according to client contracts. Complies with all applicable laws regarding billing standards
Responsibilities
- Follows up on claim rejections and denials to ensure appropriate reimbursement for our clients.
- Process assigned AR work lists provided by the manager in a timely manner.
- Write appeals using established guidelines to resolve claim denials with a goal of one contact resolution.
- Identified and resolved denied, non-paid, and/or non-adjudicated claims and billing issues due to coverage issues, medical record requests, and authorizations.
- Recommend accounts to be written off on Adjustment Request.
- Reports address and/or filing rule changes to the manager.
- Check the system for missing payments.
- Properly notates patient accounts.
- Review each piece of correspondence to determine specific problems.
- Research patient accounts.
- Reviews accounts and determines appropriate follow-up actions (adjustments, letters, phone insurance, etc.).
- Processes and follows up on appeals. Files appeals on claim denials.
- Inbound/outbound calls may be required for follow-up on accounts.
- Respond to insurance company claim inquiries.
- Communicates with insurance companies about the status of outstanding claims.
- Meet established production and quality standards as set by Ventra Health.
- Navigate websites to obtain EOBs.
- Performs special projects and other duties as assigned.
Qualifications
- High School Diploma or Equivalent.
- Two (2) year of experience posting insurance payments in a healthcare setting.
- Two (2) years of experience reading insurance Explanation of Benefits (EOB) statements preferred.
- AAHAM and/or HFMA certification preferred.
- Experience with offshore engagement and collaboration desired.
Sourced from naukri
Skills
ScreeninghrsdInvoice ProcessingAccounts PayableSettingonshoreOffshoregasoilengagementSourcingPostingClaimsHealthcareAccounts ReceivablePaymentsTeamworkResearchBank ReconciliationMedicalAccountingreconciliationexcelfinanceRecruitmentInsurance
About Ventra Health
Ventra
Healthcare
3k+
employees
2021
5 years old
Chennai, India
India
₹4.9L PA avg
Avg at Ventra Health
About
Revenue cycle management and advisory services for facility-based physicians
Industries
Healthcare
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