it engineer support
Yes Bank Ltd
Total years of experience :5 years, 5 Months
I am on 25 days contract job as backup with Yes Bank LTD Abu Dhabi, providing IT Technical Support.
Troubleshooting Laptop's & prints, unlocking & resetting AD accounts, forwarding tickets to the application team for application related issues.
• Trained newly joined candidates in specific processes and maintained documentation for appeals to insurance companies, including authorization, nursing notes, and medical documentation from the client's system.
Training process specific to newly joined candidates & show them client documents which can be used for reference while working on accounts.
Perform analysis of accounts receivable data and understand the reasons for underpayment/overpayment, days in A/R, top denial reasons, use appropriate codes to be used in documentation of the reasons for denials/underpayments.
Maintain adequate documentation on the client software to send the necessary documentation to insurance companies and maintain a clear audit trail for future reference. Also, prepare an appeals package for all insurance companies along with the appeal letters and medical Records as proof.
To provide accurate information to the payer, research available documentation including authorization, nursing notes, medical documentation on client's systems, interpret explanation of benefits received, etc. before making the calls.
Also, prepare an appeals package for all insurance companies along with the appeal letters and medical Records as proof.
Analyzing the reason for the credit balance on the account.
Analysing did the Insurance company overpaid, the Patient overpaid or Attorney overpaid on behalf of a patient.
After confirming the need to process a refund for the overpaid amount.
Need to correct adjustments If needed on account to resolve credit balance.
They will be a few calling accounts to get more clarity on payments EOB (Explanation of Benefit), RRL (Refund Request Letter), Refund Returned by Payer, and sometimes on payment recoupment/Offset payment details.
Additional responsibility to train newly joined members in a team and assist them on the floor while processing Credit Balance accounts.
Closing required the number of accounts for clients on a weekly, bi-weekly, Mid-Month, and Monthly basis. So that manager can prepare a summary on each client and sent it for approval to a client to release checks.
It’s very important to maintain every individual client requirement like the Dollar amount for the month or the number of refunds for the month.
Once the dollar amount or number of refunds are met, need to prepare and send summaries to a client for approval to issue refund checks to insurance companies, attorneys, or patients respectively.
With the manager’s oversight, prepare an issues list that could include missing documents and clarification questions. Use to handle claims for Emergency claims.
Assess and resolve enquiries, requests and complaints through calling to ensure that customer enquiries
are resolved at first point of contact.
➢ Provide accurate product/ service information to customer, research available documentation including
authorization, nursing notes, medical documentation on client's systems, interpret explanation of
benefits received etc. prior to making the call.
➢ Perform analysis of accounts receivable data and understand the reasons for underpayment, days in A/R,
top denial reasons, use appropriate codes to be used in documentation of the reasons for
denials/underpayments.
➢ Use to handle hospital claims like In-Patient claims.
Perform pre-call analysis and check status by calling the payer or using IVR or web portal services.
➢ Reaching out to insurance companies for unpaid claims.
➢ Analyzing the reason for rejection or denial of claims by insurance companies.
➢ Monitoring the receivables to ensure it is well within control.
➢ Constantly keep a track of both electronic and paper claims.
➢ Ensuring the compliance with all the insurance carriers in claims submission and other areas.