RCM Officer

Job Description

Job Description:

• Coordinates with clinicians and/or other clinical staff of different specialities for gathering relevant information/documentation for onward submission.
• Liaises with Insurance Companies/TPAs for submitting, resubmitting and replying queries raised by Insurance Companies/TPAs efficiently.
• Shows knowledge of medical terminologies and good command on pronouncing medical words.
• Demonstrates strong attention to details and ability to multitask within the fast-paced, high-pressure work environment.
• Able to manage filing and tracking approval/denials/queries and inform concerned clinicians and patients about the requested service(s) status.
• Prepares cost estimation accurately as per the current agreed terms.
• Responsible for maintaining an active database of the instructions/communication about Insurance Companies/TPAs from RCM Office.
• Practices professional telephone etiquette and customer service while making claim inquiries and quickly resolving any patient complaints and concerns.
• Provides aid to Front Desk Staff regarding Insurance Protocols and Coverage.
• Maintains strict confidentiality related to medical records and other data.

Responsibilities:

• Coordinates with clinicians and/or other clinical staff of different specialities for gathering relevant information/documentation for onward submission.
• Liaises with Insurance Companies/TPAs for submitting, resubmitting and replying queries raised by Insurance Companies/TPAs efficiently.
• Shows knowledge of medical terminologies and good command on pronouncing medical words.
• Demonstrates strong attention to details and ability to multitask within the fast-paced, high-pressure work environment.
• Able to manage filing and tracking approval/denials/queries and inform concerned clinicians and patients about the requested service(s) status.
• Prepares cost estimation accurately as per the current agreed terms.
• Responsible for maintaining an active database of the instructions/communication about Insurance Companies/TPAs from RCM Office.
• Practices professional telephone etiquette and customer service while making claim inquiries and quickly resolving any patient complaints and concerns.
• Provides aid to Front Desk Staff regarding Insurance Protocols and Coverage.
• Maintains strict confidentiality related to medical records and other data.

Qualifications:

• Bachelor’s degree from an accredited college/university. Coding and claims processing skills will be preferred.
• Certification from AAPC/AHIMA is a must.

“`