RCM - Re-Submission Supervisor

Oversee and coordinate end-to-end resubmission operations through claim analysis, team support, quality auditing, training, and interdepartmental communication to ensure accurate and efficient insurance reimbursement.

• Preparing date-wise production log for the team. (Pharmacy /Clinic)

• Facilities doubt clearing (Coding, insurance Queries).

• Sharing rejection feedback to the Submission team.

• Sharing rejection feedback to the Approval team.

• Sharing rejection feedback to the reception/registration team.

• Sharing doctor monthly rejection reports to accounts.

• Sharing recon sheet to all team members.

• Giving feedback to the resubmission team.

• Giving Induction to New joiners.

• Clarifying the queries to the Insurance Company.

• Auditing the resubmission files and sharing the feedback with the team.

• Monthly team meeting with resubmission team sharing the ideas.

• Analyzing the rejections.

• Sharing rejection updates to medical auditor to share with respective doctors.

• Doing Resubmission production for assigned facility.

• Supporting submission team for their queries

• Maintain the production log in the E-claim link DHPO from team.

• Clearing the team's queries regarding rejections.

• College Diploma - Any discipline or related fields.

• Coding Certification, CPC – Certified Professional Coder (AAPC)

Proficiency in:

• ICD-10-CM (diagnosis codes)

• CPT (procedure codes)

HCPCS Level II (supplies, equipment, services)