Test - Voice Process

Job Description

Roles and Responsibilities:

• 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.
• Assess and resolve enquiries, requests and complaints through calling to ensure that customer enquiries are resolved at first point of contact.
• 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.
• Ensuring the daily assigned accounts are resolved/ worked on.
• Escalate difficult collection situations to Team Leaders situations and seek education and instruction.