Caller

Accounts Receivable Analyst

● 2 Years of mandate experience in AR calling with Acute care/Acute business.

● Perform pre-call analysis and check the status by calling the payer or using IVR or web portal services.

● Maintain adequate documentation on the client software to send the necessary documentation to insurance companies and maintain a clear audit trail for future reference.

● Record after-call actions and perform post-call analysis for the claim follow-up.

● Provide accurate information to the insurance company, research available documentation including authorization, physician notes, medical documentation on PM system, interpret explanation of benefits received, etc. prior to making the call.

● Perform analysis of accounts receivable data and understand the reasons for underpayment, days in A/R, top denial reasons, use appropriate codes to be used in documentation of the reasons for denials/underpayments.

● Comply with all reimbursement and billing procedures for regulatory, third party, and insurance compliance norms.

● Responsible for meeting daily/weekly productivity and quality reasonable work expectations.

Responsibilities

● Claim processing and submission.

● Submit the claim to insurance companies to receive payment for services rendered by a healthcare provider.

● Taking denial status from various insurance carriers

● Checking eligibility and verification of policy

● Analysis of the data

● Converting denials into payments

● Follow Health Insurance Portability and Accountability Act (HIPAA)

● Account follow up on fresh claims, denials, and appeals.

● Checking the claim status as per their suspension and denials

● Achieving weekly/monthly production and audit target

Qualifications/Requirements

● High School (HSC) or graduate or equivalent with strong analytical skills.

● 2 Years of experience in accounts receivable follow-up/denial management for US healthcare.

● Good written and verbal communication skills.

● Knowledge of medical terminology, ICD10, CPT, and HCPC coding.

● Basic working knowledge of computers.

● Willingness to work continuously in night shifts.

Preferred

● Familiar with healthcare patient billing systems (Practice management) like NextGen, eCW, Carecloud, Docutap.

● Familiar with clearinghouse like Waystar, Realmed Availity, change healthcare, via track.

● Proficiency with MS Excel, MS Word, google spreadsheet, etc.

Other Skills and Abilities

● Ability to work independently with minimal supervision.

● Good analytical skills, assertive in resolving unpaid claims.

● Ability to multi-task and accurately process high volumes of work.

● Strong organizational and time management skills