Manager

This is an Individual Contributor Role

Roles Responsibilities:

• Must have strong experience in CPT/ ICD 10-CM Coding, Modifiers, Anatomy and Physiology, Sound surgery and E&M knowledge.
• Must possess good communication skill with neutral accent.
• Initiate telephone calls to provider office to communicate the outcome of the denial review.
• Willing to work in Eastern shift.
• Must be spontaneous and have high energy level.
• Minimum work experience in voice process will be an added advantage
• Manage claims with timely follow up.
• Must be good with MS Office, especially Excel and PPT.
• Understand the client requirements and specifications of the project.
• Ensure that the deliverable to the client and adhere to the quality standards.
• Mandatory CPC or CCS certification. "Should not have Apprentice in credential 
• Handling of inbound/outbound calls from providers and hospitals to inquire about member account queries related to (Precert, Eligibility, benefits, and claims).
• Raise request for pending/denied claims inquiry form providers.
• Create request for onshore to email/fax/post the documents or payments.
• The applicant will be responsible for handling an array of front facing duties.
• Some of these tasks including interaction with customers over the phone, via email or chat.
• Should be able to determine eligibility by comparing client’s information against the requirements (particularly for claims).
• Should demonstrate the quality of attention to details, effective and clear communication, adaptability, empathy, patience and positive attitude.
• Ensure a secure and compliant work environment.

Skill Requirements:

• Any Graduate (Except B.Tech, BCA or any technical qualification).
• Candidate should have minimum 5 year experience into international calling (inbound or outbound).
• US Healthcare knowledge with inbound calling will be preferred.
• The applicant should be result oriented and meet client's expectation and should have excellent interpersonal skills with a problem-solving ability and must maintain a high level of professionalism and present the organization in best light possible.
• Good knowledge of MS office (Especially MS-Excel).

Understanding of US Healthcare industry.