Accounts Receivable Caller ( Hospital Billing)

Who we are:

R1 RCM is a leading provider of revenue cycle services and physician advisory services to healthcare providers. We help transform and manage the commercial infrastructure of care organizations.

What you will do:

• Study and analyze the healthcare reimbursement models to ensure the revenue estimation is in-line with the contracts.
• Diagnose and understand how the underpayment occurred and what our client could have done to prevent it.
• Work on financial analysis, reviews, and deep dives on client specific healthcare data, making sure of accuracy of revenue projections and actual collections.
• To call payors for underpaid charges and get status to provide correct resolution for claims for underpayment and denials.
• To perform various analytical reviews and deep-dives (root cause analysis) on client-specific for underpayment validation and find out better way to manage calls and target simultaneously.
• Identify the reason of variance by applying all healthcare reimbursement methodology.
• Find out the status of appeals/claims through various web payor portals.
• To effectively communicate the findings/ observations with recommended action to US team/clients.
• Handling client calls and communicating effectively for task deliverables and inventory/workflow management/overdue claims management.
• Maintaining quality for each claim and provide proper comments for observations.
• Should have good understanding of notes interpretation.

What will you need:

• Graduate degree Preferably from a reputed educational institute
• Underpayment experience and knowledge
• Payer contract building experience and expected reimbursement expert with EOB knowledge.
• AR follow-up (this role does not translate 100%. In addition to calling on denials, the employee needs to be able to analyze why an account was underpaid and pursue the underpayment using various methods)
• Good calling and analytical skills, call time management is key factor to manage payor calls.
• Skills to read, understand and interpret EOB, UB/itemized bills, denial letters, appeal letter and SOPs
• Experience/knowledge of various US healthcare payors, payor portal (like Availity tool), payor websites etc.
• Excellent Communication Skills, hands on payor calling experience.
• Preferable - 2-3 years of Experience of Underpayment validation, if not available then trainable resources from (AR follow up, contract modeling in US healthcare)
• Having good knowledge about RCM cycle and denial management
• Open to work in EST/PST time zone as per process requirement.

If you are interested , share your resume to the below contact details.

HR - Ramya

Mail - Relango@r1rcm.com

Whatsapp- 9345112634