Could anyone please help with NOC codes for the following responsibilities.
Role: Senior Analyst
• As a part of Billing Department, facilitated Patient refunds, EOB Denials, Medical record request & resubmission process for US Regions
• Verify Bills as per defined standards and applicable rules
• Verify EOB details such as Patient Name, Insurance, Claim Number, Date of service & Amount
• Prepared Payment Proposals on weekly basis and forwarded them for processing the payments to respective regions.
• Worked on Trackers and interacted with the provider’s office in order to update the records with information of Patient’s for smooth flow of payments
• Developed process documentation with the new updates and process requirements
Role: Process Associate
• Excellent knowledge of EOB Posting.
• Timely post payments from various payers (i.e., government, workers compensation, commercial, etc.), and member and non-member payments.
• Posting Payments into Client Billing System with correct coding Payments or adjustments that require review by the insurance company are identified. Necessary steps are taken (i.e., letters, obtaining medical records) to prepare a review to send to the insurance company.
• Secondary insurances are identified and posted.
• Pull the remits from client websites.
Role: Claims Examiner Associate
• Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation
• Processing Health Insurance documents with 100% quality and productivity as per US client's requirement with meeting SLAS.
• Converting the Health Insurance Invoice in Database from the given Scanned Images
• Ensuring claim validation and eligibility checking.
• Report overpayments, underpayments, and other irregularities.
• Approve, reject or refer a claim to a specialist.
Role: Claims Associate
• Working for US healthcare and Insurance.
• Review the enrollment application with correct information
• Updating the Enrollee details with internal organizational applications.
• Follow the process Instruction and update guidelines.
• Checking the enrollee due balances and sending letters to them.
• Working with multiple Error codes and Work Queues.
• Maintain the Quality for enrollee satisfaction.
Role: Pharmacy Benefit Analyst
• Working with the quality management team for Pharmacy Benefit Management.
• Comparing Queries of AS400 with Planning by using MS-Excel Macros.
• Develop and run macros in RxCLAIM to implement plan requests.
• Perform claim testing to ensure accurate claim adjudication by using macros.
• Running MACRO, hand on experience in various databases like; AS400, APSI 0016, IBM BATCH PRODUCTION, APSI 0040, extract data by running QUERIES.
Role: Senior Analyst
• As a part of Billing Department, facilitated Patient refunds, EOB Denials, Medical record request & resubmission process for US Regions
• Verify Bills as per defined standards and applicable rules
• Verify EOB details such as Patient Name, Insurance, Claim Number, Date of service & Amount
• Prepared Payment Proposals on weekly basis and forwarded them for processing the payments to respective regions.
• Worked on Trackers and interacted with the provider’s office in order to update the records with information of Patient’s for smooth flow of payments
• Developed process documentation with the new updates and process requirements
Role: Process Associate
• Excellent knowledge of EOB Posting.
• Timely post payments from various payers (i.e., government, workers compensation, commercial, etc.), and member and non-member payments.
• Posting Payments into Client Billing System with correct coding Payments or adjustments that require review by the insurance company are identified. Necessary steps are taken (i.e., letters, obtaining medical records) to prepare a review to send to the insurance company.
• Secondary insurances are identified and posted.
• Pull the remits from client websites.
Role: Claims Examiner Associate
• Enter claim payments, reserves and new claims on computer system, inputting concise yet sufficient file documentation
• Processing Health Insurance documents with 100% quality and productivity as per US client's requirement with meeting SLAS.
• Converting the Health Insurance Invoice in Database from the given Scanned Images
• Ensuring claim validation and eligibility checking.
• Report overpayments, underpayments, and other irregularities.
• Approve, reject or refer a claim to a specialist.
Role: Claims Associate
• Working for US healthcare and Insurance.
• Review the enrollment application with correct information
• Updating the Enrollee details with internal organizational applications.
• Follow the process Instruction and update guidelines.
• Checking the enrollee due balances and sending letters to them.
• Working with multiple Error codes and Work Queues.
• Maintain the Quality for enrollee satisfaction.
Role: Pharmacy Benefit Analyst
• Working with the quality management team for Pharmacy Benefit Management.
• Comparing Queries of AS400 with Planning by using MS-Excel Macros.
• Develop and run macros in RxCLAIM to implement plan requests.
• Perform claim testing to ensure accurate claim adjudication by using macros.
• Running MACRO, hand on experience in various databases like; AS400, APSI 0016, IBM BATCH PRODUCTION, APSI 0040, extract data by running QUERIES.
