Denials Management Associate- RCM Only
- Bizmatics India
- 1 - 4 years
- Mumbai
- 21 days ago
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Job Description
JOB SUMMARY:
Denial Management Associate responsibility is to work on claims which include coding errors, duplicate claims, lack of medical necessity, patient eligibility issues, and insufficient documentation. A high denied-claims rate hurts a physician practices financial bottom line because they are not getting payment for services rendered. Managing denials to decrease denial rates helps healthcare providers ensure they are billing medical services properly and receiving adequate payment for their services in a timely manner. Effective denials management can significantly improve the healthcare practices financial health and patient satisfaction.
Skillsets required/Primary Functions:
- Knowledge of medical coding: Understanding HCPCS Level II, ICD-10-CM, and CPT codes and ensuring the codes support physician documentation will help prevent denials due to coding errors.
- Understanding insurance policies: Professionals in this field need to understand different insurance policies, coverage details in the EOB, and the reasons why claims might be denied.
- Analytical skills: The ability to analyze denial patterns and identify systemic issues is important for preventing future denials.
- Communication skills: Strong written and verbal communication skills are essential. Denials managers need to communicate with insurance companies, healthcare providers, and sometimes patients.
- Attention to detail: Given the complexity of medical billing and the potential for errors, attention to detail and investigating the reason for denials will help put an end to unnecessary denials.
- Problem-solving skills: The ability to solve problems and find solutions is important, especially when it comes to overturning denied claims.
- Knowledge of the revenue cycle: Understanding the entire revenue cycle will help to identify where issues are occurring, where the cash flow is bottlenecked, and how to fix it.
Job Qualifications:
Minimum Qualifications:
1. Bachelors degree in accounting, Finance, Business Administration, Commerce, or a related field(preferred}
2. 1-3 years of experience in medical billing, AR calling/worked as Denial specialist, or revenue cycle management
Shift Timing - Night Shift
Job Location- Vikhroli (Mumbai)
Interested candidate can share cv on po**a@ha***********r.com
Job Classification
Industry: BPM / BPOFunctional Area / Department: Healthcare & Life Sciences
Role Category: Healthcare & Life Sciences - Other
Role: Healthcare & Life Sciences - Other
Employement Type: Full time
Contact Details:
Company: Bizmatics IndiaLocation(s): Mumbai
Keyskills: Denial Management Denial Handling US Healthcare RCM Medical Billing
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