Locum Resubmission Officer

Job Description:

Handles resubmission of denied claims, coordinates responses to queries, and reviews rejections from payers, assigning codes accordingly. Compiles reconciliation sheets, conducts denial analysis, provides feedback, and oversees the training of new joiners. Monitors denial trends, reporting findings to the Supervisor and ensuring feedback to the concerned unit.

Responsibilitie

s:•Handles resubmission of denied claims, adhering to work allocation and denial analysis, and providing timely feedbac

k.•Coordinates with both internal and external stakeholders to ensure prompt responses to emails and queries regarding resubmission

s.•Conducts review of rejections from payers, assigning appropriate codes based on physician responses to post-rejection querie

s.•Compiles quarterly or semi-annual reconciliation sheets and engages in follow-up communication with payer

s.•Performs denial analysis and provides feedback to all relevant stakeholders involve

d.•Trains and guides new joiners in the resubmission proces

s.•Monitors denial trends, report findings to the Supervisor and ensures feedback is provided to the concerned uni

t.

Qualificati

ons:•Bachelor's Degree in any field, Medical prefe

rred•Minimum of zero (0) to two (2) years of experience in the Insurance Departm

ent.•Knowledge of Claims Resubmission, Spreadsheets, and Software Modu

les.•Skills in Current Procedural Terminology (CPT) Cod

ing.•Skills in utilizing Health Information Systems (HIS) softw

are.•Ability to speak and write in English fluen