· Reviewed and analysed insurance claims submissions to ensure accuracy and compliance with payer requirements.
· Managed denied claims by making outbound calls to resolve issues efficiently and communicating effectively with insurance representatives to negotiate resolutions and expedite approvals.
· Developed and implemented best practices for handling denied claims, resulting in improved turnaround times.
· Investigated denied claims by assessing reasons for denial, gathering necessary documents for appeals, and maintaining detailed records of all communications and actions for follow-up and auditing.
Participated in regular meetings to discuss denial trends and develop strategies for improvement, enhancing overall revenue cycle efficiency.
Engaged in ongoing training and compliance activities.
Collaborated with various teams to ensure seamless workflow processes.
· Assisted in providing process training to new team members to facilitate understanding of organizational procedures.
· Summarized and presented case studies provided by the organization.
· Attended learning and development programs, including managed care services, consulting, and leadership meetings with clients.