Insurance Claims Processor

18 hours ago


Lahore, Punjab, Pakistan HRMD Solutions Full time

Responsibilities:

The AR Follow-up Specialist will play a key role in managing and collecting outstanding accounts receivable within the revenue cycle management process.

  • Key Tasks:
  • You will verify patient eligibility and benefit verification through calls and web portals.
  • You will review and verify medical codes, including CPT, ICD-10, and HCPCS.
  • You will transmit corrected claims electronically or by paper according to payers' requirements.
  • You will monitor and follow up on unpaid or denied claims to ensure timely resolution.
  • You will contact insurance companies to inquire about claims status and facilitate payment.
  • You will review aging reports regularly to prioritize and address delinquent accounts.
  • You will initiate appeals for denied or underpaid claims and track the appeal process.
  • You will develop denial management strategies to minimize future denials.
  • You will maintain detailed records of appeals.
  • You will understand insurance policies, reimbursement methodologies, and billing guidelines.
  • You will collaborate with billing and coding teams to address recurring issues.
  • You will investigate and resolve discrepancies in payments, adjustments, or denials.
  • You will identify claim processing issues and general billing trends.

Requirements:

  • Bachelor's Degree from a reputable institution or university.
  • 1 to 2 years' experience in medical billing - accounts receivable and denial management.
  • Knowledge and understanding of USA health insurance guidelines, especially Medicare and state Medicaid.
  • Experience in Pain Management, Lab, Anesthesia, Psych/TMS, RTM, CCM.
  • Strong communication skills are essential.
  • Must have a strong grip on MS Office.


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