Jagannathan Ravikumar

Managing the Accounts Receivable:

• Reconciling accounts receivable, ensuring accurate recording of payments.
• Tracking outstanding payments and identifying issues.
• Processing and submitting claims.

Analyzing Claims and Denials:

• Analyzing and resolving unpaid medical claims.
• Following up with insurance companies to inquire about claim status and resolve issues.
• Identifying root causes of denials and developing strategies for improvement.

Communication and Follow-Up:

• Communicating with insurance companies regarding billing issues.
• Responding to patient inquiries about their bills.
• Following up on outstanding balances and denied claims.
  

• Accurately Post Payments: Enter all patient and insurance payments (including adjustments, denials, and refunds) into the billing system, ensuring accuracy and timeliness.
• Reconcile Payments: Balance posted payments against bank deposits, explanation of benefits (EOBs), or electronic remittance advice (ERAs) to ensure accuracy and identify any discrepancies.
• Manage Payment Posting Issues: Identify and resolve payment posting issues, including unapplied cash, and unclaimed payments.

Identifying and Analyzing Denied Claims:

• Review the Explanation of Benefits (EOB) statements for denial codes and reasons.
• Categorize denials (e.g., medical necessity, coding errors).
• Identify trends and patterns in denials.
• Analyze the root causes of denials and recommend corrective actions.

Appealing Denied Claims:

• Prepare and submit appeals for denied claims.
• Communicate effectively with payers to explain the reason for an appeal and request a payment.
• Document the appeals process and track the outcomes.

Tracking and Monitoring Progress:

• Track denial rates and trends to identify areas for improvement.
• Monitor the status of appeals and report on the outcomes.
• Participate in quality improvement activities related to denial management.