An A/R representative is responsible for timely and accurate follow-up and appeal of denials/rejections received from third-party payers. The representative will manage their assigned work to ensure payer appeal/filing deadlines are met and achieve optimal payment for services rendered.
Graduate with 1-5 years’ experience in US health care industry (HB or PB – HB preferred).
Ability to read and interpret insurance explanation of benefits (EOBs
Knowledge of payer edits, rejections, rules, and how to appropriately respond to each.
Accuracy in identifying the cause of rejections/denials and selecting the most appropriate method for resolution.
Process – Credentialing
Designation: Credentialing and Enrollment Specialist