“Outsourcing components of our billing services to MedCloud has been a great experience for us. It has enabled us to streamline our operations and raise our bottom line.”
A North East RCM Company
Executive
Medcloud's Collectors
Medcloud’s Medical Collectors have the primary responsibility of reviewing all insurance claim determinations and take all further steps necessary to satisfy payment including but not limited to corrections, insurance appeals, and/or negotiate the claim.
Duties include, but are not limited to:
- Reviews insurance correspondence and identifies, reports and responds to overpayment requests and recoupments
- Negotiates settlement offers from Third Party Negotiation companies to expedite payment and circumvent the appeal process
- Identifies and processes anti-assignment payments per protocol
- Deals directly with the third-party administrator, insurance carriers, and workers comp. adjusters to successfully perform redeterminations.
- Uses internal software for filing appeals (both ERISA, and non-ERISA) to insurance carriers and employer groups stating a sound case as to why there should be additional reimbursement on a medical service performed
- Performs other charged responsibilities include dealings with the insurance companies to verify eligibility and benefits, assignment/anti-assignment, disputing patient coverage and following up on appeals, negotiations and redeterminations
- Review tasks daily to assure all account that require additional follow up get completed
- Clears assigned correspondence daily.
- Prepares accounts for external review, as needed.
- Assists with related special projects, as required.