Client-specific guidelines and Maintain data confidentiality and Interview / claims processing standards security questioning Demonstrate research capability appropriate guidelines when processing claims 3.1 Manage Record the appropriate Lecture Written exam mathematical 4 Manage account payments and balances Discussion Demonstration tools/accounting process medical receivable Create report log to Demonstration Interview Communication skills claims communicate action items for Project type Research skills payers and providers re Medical documentation documentation Computer operation Checks various payer portals for payment status and reasons for non-payment Performs data to post payment 3.2 Manage Identifying the components of an Lecture Written exam 4 Explanation of Benefits denied/ Explanation of Benefits Demonstration Demonstration Insurance Policies rejected Interpreting Explanation of Case study Interview/ Common Reason for Claim claims Benefits of a denied claim questioning denials Interpreting an Explanation of Measure to Prevent Denied Benefits of a rejected claims Claims Identifying common reason for Communication Skills claim rejection Common Reason for Claim Identifying solution for identified Rejection reason for rejection Rebilling Process for Rejected Claims 3.3 Manage Identifying common reason for storming Written exam 4 Common Reason for underpaid claims underpayment Discussion Demonstration Underpaid claims claims Identifying measures to prevent Demonstration Interview Measure to Prevent underpayment of claims Case study underpaid Claims Rebilling process for underpaid claims
Client-specific guidelines and claims processing standards Maintain data confidentiality and security Demonstrate research capability appropriate guidelines when processing claims Interview / questioning Manage medical claims 3.1 Manage account receivable mathematical tools/accounting process Communication skills Research skills Medical documentation Computer operation Record the appropriate payments and balances Create report log to communicate action items for payers and providers re documentation Checks various payer portals for payment status and reasons for non-payment Performs data to post payment Lecture Discussion Demonstration Project type Written exam Demonstration Interview 4 3.2 Manage denied/ rejected claims Explanation of Benefits Insurance Policies Common Reason for Claim denials Measure to Prevent Denied Claims Communication Skills Common Reason for Claim Rejection Rebilling Process for Rejected Claims Identifying the components of an Explanation of Benefits Interpreting Explanation of Benefits of a denied claim Interpreting an Explanation of Benefits of a rejected claims Identifying common reason for claim rejection Identifying solution for identified reason for rejection Lecture Demonstration Case study Written exam Demonstration Interview/ questioning 4 3.3 Manage underpaid claims Common Reason for Underpaid claims Measure to Prevent underpaid Claims Rebilling process for underpaid claims Identifying common reason for claims underpayment Identifying measures to prevent underpayment of claims storming Discussion Demonstration Case study Written exam Demonstration Interview 4