medical billing and coding

? Work on DHPO and Pulse reporting system to prepare monthly claims submission report.
? Extract/download submission and remittance XML file to prepare submission and remittance advice report.
? Prepare claim submission report insurance wise to follow up with individual insurance company.
? Prepare Submission Data Facility wise and report to Manager.
? Monitor on individual Facility revenue and report to Manager.
? Prepare Aging analysis report and clearing above 60 Days claims.
? Send Claims outstanding report weekly basis to all insurance and TPA.
? Follow up meetings weekly basis with insurance and TPA for collection and reconciliation.
? Request Bank collection from treasury Dept to match DHPO remittance advice.
? Monitor on Insurance payments and same initiating to treasury team.
? Payment posting or allocation for fully/partially paid claims in Excel and in Billing Software.
? Send Rejection report for justification
? Once justification received forward to resubmission team to resubmit the claim.
? Follow up with Charge entry, Coding, submission and resubmission team to submit the claim in stimulated time.
? Prepare Monthly report of collection and receivable.
? Work for Reconciliation and rejected claims and getting sign off.
? Support pricing team for pricing related issue (PRICE-001, 002, 003, 004).
? Analyze on rejected claims and working on technical claims (Timely and AUTH)
? Monitor claims aging bucket and assign to team to work based on priority.
? Pricing and contracting with insurance companies.
? Prepare volume rebate to all insurance companies based on contract.

Work Terms

per hour