Magna Infotech Pvt Ltd jobs - RCM Specialist

Education background: B.Pharma/ M Pharma (Mandatory) - 2017 onwards Pass out

Exp level: fresher.

Night shift

Cab Facility Available

• Strong customer service skills; answering client, patient and carrier calls; prompt return and follow up to all interactions; prompt response to requests for information
• Timely management of unpaid claims as assigned, through the use of the client’s office manager; ageing reports; correspondence; Clearinghouse and PM rejections; SharePoint
• Effectively handle complex payer denials; responsible to ensure that secondary claims are sent and paid
• Monitoring and reconciliation of claims
• Timely posting of payments and identifying adjustments and differences in payments
• Expert ability to input specific data and review patients’ issues and credits
• Knowledgeable of medical EOB’s, patient deductibles and co-pays, and insurance or third party correspondence
• Ability to conduct a contract rate audit and provide notification to Supervisor of underpaid or pay equal charges; provide Claim Edit Reports and Unassigned Money Reports as requested
• Effectively work with clients and group to facilitate information and resolve charge questions
• Capable to create a credit/debit report and denial reports in order to provide critical information to the AR Specialist
• Expert ability to add specific data such as modifiers, payer-specific information, including authorization criteria, CPT and ICD-9 code and date of injury (DOI)
• Understand and interpret the Correct Coding Initiative (CCI)  as it applies to charge entry work with CHMB
• Timely and efficient input and reconciliation of batches
• Responsible for the processing and discrepancy reconciliation and closing of charge batches across all systems
• Work with clients and group to facilitate information and resolve charge questions
• Achieve the goal of a 48-hour turnaround batch time
• Complies and enforces and policies and procedures
• Achieve goals set forth by supervisor regarding error-free work, transactions, processes and compliance requirements; Specific goals include 1,400 accounts worked per month
• Other duties as assigned