AR Analyst

Account Receivable Analyst (AR)

About the company: Established in 2003, Nath Outsourcing Solutions Pvt. Ltd. (NOS) specializes in end-to-end solutions for the US Healthcare Industry. Our expertise includes managed care, payer rules, coding, and compliance, all supported by advanced technology and a deep understanding of Revenue Cycle Management (RCM) concepts. Our team of highly skilled professionals is committed to delivering superior service through efficient management and competitive excellence, ensuring we meet and exceed client expectations consistently.

Job Summary: The AR Analyst for Lab Billing manages financial transactions, ensuring accurate billing and timely collections.

Role & Responsibility:

Diverse Payer Experience: Candidates should have experience working with a variety of payers, including major ones like Medicaid, Medicare, BCBS, UHC, Humana, and Aetna.

Medical Records and Reconsideration/Appeals: The candidate should understand how to prepare documents and submit them to insurances accordingly. Medicaid and HMOs: As these are our key insurances, the candidate should at least be familiar with what Medicaid is, the eligibility criteria, how the plan works, and the differences between Medicaid and HMOs.

Types of Plans: Candidates should know the type of plans—HMO, PPO and POS—including their coverage benefits and how they affect claims when a provider is in-network or out-of-network. Authorizations: The candidate should understand what an authorization is, why it is necessary, and its importance in the claims process Strong understanding of Patient eligibility determination, Coverage criteria for Medicaid and Medicare, Different insurance plan types (HMO, PPO, POS).

Candidates should be familiar with handling a range of denials, not just those related to authorizations or referrals. Strong Authorization and Referral Understanding: Knowledge of authorization processes and how referrals work within the billing context.

Candidates must demonstrate a clear understanding of RCM principles, including patient responsibilities and deductibles. Practical Experience with Key Billing Procedures like medical records requests, reconsiderations, and appeal submissions is essential.

Additional Considerations: Experience:

Prioritize candidates with at least 2-3 years in medical billing, preferably in lab billing / physician billing. Immediate joiners with hands-on experience in US healthcare, particularly in lab billing, are preferred. Adaptability: Look for candidates who show a willingness to learn about new payers and processes. Problem-Solving: Consider those with a proven track record of successful resolution in billing scenarios.

Technical Skills: Proficiency in CT, Nextgen, and E Clinical Works (ECW).

Shift timings – Night Shift (6:30 PM IST To 3:30 AM IST)

Working days – 5 Days (Monday – Friday) Location - Plot No: I-48, Sector 83, Alpha IT City, Mohali 160055

Email ID - Team-HR@Nath-mds.com / hanand@nath-mds.com