Supervise the work of all employees including planning, organizing and technical work.
Monitor and ensure attendance of all employees in the department.
Keep the TBH team regularly informed about all activities.
Assign and oversee project work undertaken by the department.
Make proposals for improvement and maintenance of facilities such as chairs, electronic devices,
and office equipment.
Ensure that all members of the team perform their duties in time and for full duration with
dedication, motivation, and high quality of performance.
Assist TBH in scrutinizing the applications of employees for the departments.
Attend meetings of the respective department.

Conducting regular audits of representative claim work for accuracy and quality.
Providing direction to client leads on claim audit corrections and resolution.
Preparing and analyzing reports of audit review and performance issues with a focus on identifying trends, instituting continuous quality improvement initiatives, and identifying and providing ongoing training opportunities for representatives.
Providing second tier review on advanced and escalated claims issues to a satisfactory resolution.
Logging all client issues encountered in internal tracking system, including enhancement requests, bugs, errors, and inquiries.
Reviews coding/billing requirements of all active LCDs, NCDs, Articles, Payer notifications and third party Medical necessity relating to assigned Payers/Plans/MAC/FI and/or Carriers.
Updates Cranewares Medical Necessity Product by comparing application records with CMS database, payer websites and payer policies and billing/coding guidelines.
Weekly review of Commercial website policies to identify and maintain all clinical procedures requiring prior authorization.
Formats policy data into required formats (extraction of data into Craneware format).
Maintains a high level of integrity of data entered in tables in accordance with Standards of Operation Guidelines and Regulatory best practices.
Develops and maintains knowledge and expertise of the Regulatory Mapper and the selection process for entering medical necessity policies, QA of policies as well as the proper selection of the types of policies which apply.
Weekly performs QA of all data entered, including ensuring accuracy of data entry and review of conflicts of groups within the defined payer.
Weekly performs QA of text to ensure all links are entered correctly.
Weekly utilizing the QA tool, review updates for accuracy of entry.
Weekly reporting of retired, revised and new policies by payer.

Assure timely collection of monies due to corporation.
Monitor and report on deviations from credit standards.
Assure timely and accurate invoicing.
Manage cash application making sure all cash receipts are applied properly
Assure that the companies standard template regarding invoice sample is in place for every customer
Conduct credit checks on all customer, establish and manage limits
Make recommendations to improve quality of invoicing and collection procedures.
Weekly reporting of invoicing totals/aging totals/cash receipts/invoice adjustments.

To enter Demographics and diagnostic codes according to insurance guidelines.
To check patient ‘s Insurance policy information using insurance web portals
And by calling insurance Customer Service lines.
To ensure Quality of entering Data
To call Doctor offices to check patient insurance information.
AS AR EXECUTIVE .
To work on Rejections received after electronic claim submission.
To Fix all Rejected claims by Emdeon Clearing house.
To call patient if necessary to get insurance information.
To fix claim with different reason codes.
To maintain quality and quantity of the work according to Clients requirement.

Provided continual support to departments’ managers and ensure the employee welfare is maintained.
• Responsible for supervising customer service agents and other staff. Trains, coaches, and mentors employees on how to deliver the best customer service possible.
• Asked customers to provide feedback on agents and customer service experience.
• Handled major incidents that cannot be resolved by agents.
• Reviewed and planned departmental activities to ensure business value was driven.
• Provided leadership and training to newly hired executives and continued to facilitate service strategies.

Provided continual support to the employees on HR & Admin matters.
• Designed and implemented leadership programs.
• Developed and produced marketing/promotional materials to promote benefits of new products.
• Developed and implemented appropriate training and development of Customer Services Executives.
• Responsible for selecting countries to be covered.
• Worked closely with HR on new company acquisition integration for new employees.
• Conducted interviews with government officials and corporate leaders to kick start projects.
• Worked with the business leaders to support key business initiatives through training activities.

Performed all aspects of customer support, including answering telephones, coordinating special promotions, and providing details for products and services.
• Handled inbound sales duties, including order entry processing and fulfillment.
• Resolved billing questions and disputes, initiated customer calls, and performed data entry.
• Served customers by providing product and service information; resolving product and service problems.
• Resolved product or service problems by clarifying the customer's complaint.
• Answered participant questions, as well as question participants to obtain full understanding of what information is being requested.
• Interacted with customers extensively to maintain customer satisfaction.