Job Description – L2 Roles (Non-Voice)

1. Eligibility Resource

• Experience in Eligibility Verification Process.
• Good typing skills.
• Ability to obtain eligibility information from various insurance portals.
• Quick learner with good communication skills.
• Minimum 12+ months of experience required.
• Work from office is mandatory.

2. Charge Review/Entry

• Experience in Demo & Charge Entry Process.
• Exposure to working on Edits.
• Understanding of CPT codes & claim specialties.
• Familiarity with HCFA Forms.
• Ability to clear scrubs/edits.
• Minimum 18 months of experience required.
• Ability to fix charges pended for various reasons.
• Work from office is mandatory.

3. Edits/Clearing House/Claim Submission

• Experience in Clearing House operations.
• Exposure to working on Edits.
• Strong understanding of Clearing Rejections & Payer Rejections.
• Knowledge of how clearing houses function.
• Ability to analyze rejections and provide inputs to managers to improve first-pass ratios.
• Minimum 18 months of experience in Clearing House & Insurance Rejections.
• Good understanding of Claim Forms & EDI Process.
• Familiarity with HCFA Forms.
• Ability to clear scrubs/edits.
• Ability to fix charges pended for various reasons.
• Work from office is mandatory.

4. Payment Posting & Credit Balance

• Strong understanding of ERA Payments & working on ERA Exceptions/Kickbacks.
• Knowledge of processing correspondence.
• Experience in manual/ERA payment posting.
• Ability to handle takebacks/off-sets.
• Ability to meet client expectations.
• Minimum 18 months of experience in Payment Posting.
• Work from office is mandatory.