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· Work as Claims and rejection Auditor in Revenue cycle management ,

· Job Responsibilities includes claims from Insurance Companies.

· Maintain strict confidentiality of patient information in accordance with company policies.

· Answer calls received in the insurance phone queues professionally and within established standards.

· Comply with all data entry processing and procedures related to internal systems, databases and applications.

· Ensuring patients membership validity and insurance coverage.

· Enter ICD10 codes for patient complaints and diagnosis.

· Enter codes for patient request of procedures and other requested items.

· Provide written approval through e-mails, faxes, and computer generated system.

· Applying intended coinsurance and deductible as per insurance policy.

· Application of adjudication procedures to make sure proper payment of claims.

· Review pending and denied claims submitted by providers for reevaluation.

· Provide actual decisions for approval and denial in due time.

· Providing quality customer service to members, providers, and other insurance companies.

· Studying rejection and do medical discussion to minimize rejection through negotiation with different insurance companies.