I worked in a contact center for 2 in a half years, specifically mainly dealing with healthcare account, my daily task is to answer inbound calls from different clinic and hospitals we call them providers we are assisting them to share more information regarding patient’s benefits and eligibility. In health insurance verification it is the process of checking a patient’s active coverage with the insurance company. It also verifies the eligibility a patient’s insurance claims, Verifying a patient’s insurance plan must be done before the patient gets admitted to any hospital, clinic or medical facility in order to avoid claim rejection. Filing for claims rejection is such a hassle and very time-consuming. Make sure that the written patient information written is correct and up-to-date . After 3 months as a benefits and eligibility verifier I got upskilled as medical claim specialist and since I’m a benefits and eligibility before I handle both if we were received either benefit or claim information from our callers. As a medical claim specialist, or also known as
processing claims, negotiating settlements, verifying insurance coverage, and reviewing insurance cases. We are basically the one who’s giving out claim information like, giving out denial information and guiding our provider what to do or what needs to submit if they received any denials from the insurance, giving out payment details, check details and explaining if there’s a recoupment on their payment. After 2 in a half years working in a contact center, I am also an experience home health medical biller and authorization processor for commercial plans for 8 months, it is like a virtual assistant but we have an employer. Basically, I am working directly with the owner of home health agency which is located in Houston, Texas. My daily task there is to process and request authorization for home health discipline from commercial payers, and as a medical biller I am in charge to of calculating and collecting payments for medical procedures and services, I am the one who’s correcting the claim information by using UB04 form and CMS1500, this also includes updating patient data, developing payment plans, and preparing invoices we create invoices using quickbooks intuit. I investigate and appealing denied claims, helping patients develop patient payment plans, Collecting and reviewing referrals and pre-authorizations, Monitoring and recording late payments, and we always Ensuring the patient’s medical information is accurate and up to date. We have a specific software to file this information like Kinnswer software, Axxess Home health Axxess RCM, Waystar: revenue cycle management and we also use Zoho Mail, Ring Central and Logix Mobility for communication.
