Insurance Claims Processing Agent
3444 views | Apply Before: 2025-03-15
Job Summary
No. of Vacancy
3
Job Type
Full Time
Offered Salary
Negotiable
Gender
Any
Career Level
Mid Level
Category
N/A
Experience
At least 2 years of experience
Preferred Education
Bachelor's degree
Location
Naxal, Kathmandu
Apply Before
2025-03-15
Job Description
Key Responsibilities:
- Insurance Verification: Verify patient insurance eligibility, coverage details, co-pays, and deductibles prior to submitting claims, ensuring accurate information is provided for successful billing.
- Claims Submission: Submit claims to insurance providers via EHR systems or insurance portals, ensuring completeness and accuracy.
- EOB Processing: Review Explanation of Benefits (EOB) statements from insurers, post payments, and reconcile discrepancies between the insurance payment and the billed amount.
- Denial Management: Identify, investigate, and resolve denied claims. Collaborate with the coding and verification teams to correct errors, resubmit claims, and ensure timely resolution.
- Documentation & Reporting: Maintain clear and accurate documentation of insurance verifications, claims submissions, denials, and resolutions for audit purposes.
Collaboration: Work closely with the billing team and medical staff to ensure seamless claim processing and resolution.
Job Specification
Qualifications:
- Experience: At least 2 years of experience in insurance verification, claims submission, EOB processing, and denial management within a medical billing environment.
- Familiarity with Billing Systems: Experience with electronic health record (EHR) systems, billing software, and insurance portals.
- Strong Analytical Skills: Ability to identify trends in denied claims, analyze issues, and implement solutions to resolve payment delays.
- Attention to Detail: Strong attention to detail and ability to ensure that all insurance information and billing data are accurate.
- Communication Skills: Excellent written and verbal communication skills to effectively liaise with insurance providers, patients, and internal teams.
Knowledge of Insurance Terms: Familiarity with insurance terminology, claim forms (UB-04, CMS-1500), and insurance payer policies.
Software Company
Innovative, efficient and optimized innovations to pioneer cutting-edge solutions customized to adapt the needs of the client. We thrive to bring world-class technological reforms to existing processes to ensure efficiency at optimum costs.
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