Perform pre-call analysis and check status by calling the payer or using IVR or web portal services.
Maintain adequate documentation on the client software to send necessary documentation to insurance companies and maintain a clear audit trail for future reference.
Record after-call actions and perform post call analysis for the claim follow-up.
Provide accurate product/ service information to customer, research available documentation including authorization, nursing notes, medical documentation on client's systems, interpret explanation of benefits received etc prior to making the call.
Perform analysis of accounts receivable data and understand the reasons for underpayment, days in A/R, top denial reasons, use appropriate codes to be used in documentation of the reasons for denials / underpayments.