Submit claims and correspondence to insurance companies, patients and/or all responsible parties.Document helpful information on how to properly bill a claim to avoid denials in the futureCall patients to obtain the necessary information to be able to bill out claimsKeep accounts updated with the payment status/patient informationIdentify delinquent accounts and resolve with appropriate verbal and written correspondence or noticesResearch and resolve problem transactions identified on a daily basis

Errors and OmissionsChecks Internal or External Errors, issues that are raised in the DepartmentTracks and monitors all the errors and issues on claims processing raised by the clients for documentation and discussion purposesCoordinates with the company project managers for any discussed modifications with the system for minimization or elimination of errors, cost and delays in claim processingClaims Correction and Invalidations – Reimbursement and direct billingCoordinates un-validation request to the Head of OperationsCreates and discusses procedures and protocols in claim corrections with the stakeholders so as to promote transparency with our clientsMonitors and supervises Claim corrections and AdjustmentsAssistant Team Leader - Processing Team 1Processes claims generated by Priority and International providersProcesses claims with but not limited to encoding of medical claims in the system accurately and in timely mannerGenerates Turn Around Time (TAT) Report for the team to make sure claims delivery at earliest possible timeEvaluates claim according to beneficiary policy terms and conditionsAudits the team processed claims to ensure data quality, reliability and free of deficienciesMember of the Processing Quality Task ForceDevelops tools for quality control and quality assurance in claims processingPlans, creates and discusses protocols and procedures in claims processingCoordinates with the Quality Assurance Department and the Head of Operations with regards to all issues of quality in claim processing