Key Responsibilities:
Outbound 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.
Qualifications:
- Minimum of 1 year of experience in medical billing, insurance claims, or a related field.
- Strong English proficiency, both verbal and written.
- Familiarity with healthcare regulations and industry guidelines.
- Excellent communication skills with the ability to make outbound calls to insurance companies and payors.
- Detail-oriented and able to maintain accurate records.
- Ability to work independently while adhering to internal guidelines and procedures.
- Proficiency in Microsoft Office Suite or similar software; experience with medical billing software is a plus.
