🎁 Before you apply, rehearse this interview. Create your free WorkMundi account and get an Interview Training on HelpsYouSpeak — no cost, no card. I want my training →
Key Roles & Responsibilities - Review and analyze denied, rejected, and underpaid hospital claims. - Contact insurance companies via calls to determine claim status and denial reasons. - Investigate authorization, eligibility, coding, medical necessity, duplicate, and billing-related denials. - Work on denial corrections, claim resubmissions, and reconsiderations. - Prepare and submit appeals with supporting documentation when required. - Follow up on outstanding accounts receivable to ensure timely reimbursement. - Utilize payer portals, IVR systems, and billing software to research claims. - Maintain accurate documentation of all actions taken on accounts. - Escalate complex denials to appropriate internal teams when necessary. - Identify recurring denial trends and recommend process improvements. - Meet productivity, quality, and collection targets as defined by the client. - Ensure compliance with HIPAA, payer guidelines, and hospital billing policies .