Primary Roles Responsibilities
Answer Incoming calls and also make outbound calls.Ensure that right patient is identified before disclosing informatio
nListen to Customer queries and resolve and provide solutions, if unable to resolve, have the same escalated to the supervisors If Insurance query, respond appropriately, also obtain relevant missing info from the patient so that claim can be processedUnderstand and handle disputesDetailed docu
mentatio
nEfficient Call Handling TimePotential Follow Up Methods Payment in Full and Partial Payment discussio
nsUnderstand difference between dispute & objectio
nEffective rate of speech - good communication & neutral accent Obtain Insurance details from patientsObtain Additio
nal Info - Referral Information / PCP information, etc.Call for accidental Information like DOA Demographic details/ Mismatch in Name and DOBUpdat
e patient a
bout their out of pocket expensesObtain WC details, Injury Date COB Update/ABN/AOB pendingAppointment Scheduling, Appointment Cancelation, Appointment Reminder
Secondary Roles Responsibilities
Maintain professio
nal decorum and punctualityPlan leaves well in advanceEnsure good interperso
nal relation is maintained while coordinating
Compliance
Ensure privacy and security in the operation and in the operation area that includes work from office and home.Ensure you have acknowledged all the Organizatio
nal policies as per HR ProcedureEnsure you are attending the Compliance awareness and refresher sessions & other security training programs as per L&D ProcedureEnsure you are aware of agreed SLA of the projects you are working.Follow all the Information security guidelinesReport any Security & Privacy incidents to your reporting manager/ HR/Compliance Team/CISOEnsure Confidentiality, Integrity & Availability of Data/information you handleAdhere to the NDA & co
nfidentiality AgreementAdhere to the Micro Company's CISO's roles & respo
nsibilities if you are a Micro Company Compliance SPOC