AR Representative
Account:
Precertification
o Assist the Pre-Authorization Manager in processing clinical information.
o Enters and retrieves information from various automated systems and prepares
specialized reports.
o Makes contacts to obtain missing information for incomplete forms.
o Advises clinical staff of problems with insurance authorizations and
re-submits requests with additional or revised information
o Verifies insurance eligibility with third party payers using internet websites.
Senior Customer Service Associate
Account: Appointment Setter
o General customer service.
o Demographic entry and changes.
o Assist in setting appointments for patients and double-check appointment confirmation.
o Verification of insurance Eligibility.
o Deferring queries to your line manager if you are unable to answer them.
o Record and update patient’s demographics, clinical diagnosis, requested exam, scanning
clinical notes, and physician contacts.
o Reach out to the doctor’s office to obtain a missing order, authorization or exam
clarification.
o Conduct outbound calls to reach patients who are ready to schedule for radiology.
o Check CPT codes, diagnosis, ICD 10, authorization and order before scheduling
appointments.
• Customer Service Associate
Account: Insurance | Provider Services (Medical)
o Checking patients’ eligibility and benefits
o Prior authorization inquiry
o Intake |creating authorization
o Checking claims, denied claims, corrected claims
Experience: 1 - 2 years
Account: United Healthcare Group | Provider Services (Medical) o Checking patients’ eligibility and benefits o Prior authorization inquiry o Intake |creating authorization o Checking claims, denied claims, corrected claims
Experience: 6 months - 1 year
• Accounts Receivable Representative Account: Precertification o Assist the Pre-Authorization Manager in processing clinical information. o Enters and retrieves information from various automated systems and prepares specialized reports. o Makes contacts to obtain missing information for incomplete forms. o Advises clinical staff of problems with insurance authorizations and re-submits requests with additional or revised information o Verifies insurance eligibility with third party payers using internet websites.
“My business would not be able to go forward if it was not for them”
Gaurab - Adhikari
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