o Calls insurance to request claim be adjudicated
o Following up on the claims send for adjudication.
o Gathers all required appeal information for denied cases to assist in drafting the appeal
o Updates information in practice management software: Billing notes and status.
o Request client if additional medical records are needed.
o Confirms payment details if claim was paid, including payment details, date and set’s follow up task
o To maintain daily productivity report.
o To draw OCR (Open Claim Report) from the system
o To prioritize the pending claims for calling from the aging basket
o To schedule the calls as prioritized to US carries and patients by considering the time zone difference in IST and US time-zone applicable
o To make a physical call by following the international norms and applicable rules for confidentiality and HIPAA compliance
o To report the outcome of the call in the appropriate system and to advise the team in data-team in RCM for corrective action.
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