Team Leadr - Network Reconciliations
Current1. Built a dashboard for tracking the rejections before and after resubmission, alongwith a number of other factors like claim cost containment across IP, OP, Day Case and Pharmacy Claims for having a business preview before going into negotiation for final recon payment with healthcare providers.2. Preparing reserves and sharing it the payers for a potential payback as part of recon payment while keeping an eye on loss ratio of different policies.3. Coordinating with claims and finance department for claims processing and payment for answering the provider queries.4. Implementing new regulations circulated by regulatory authorities and having regular internal and external meetings for impact analysis on the business performance.5. Negotiating the Early Payment Discounts and Volume Rebates with the providers and preparing the data sets for annual collections for meeting internal revenue generation targets.