Posted:4 hours ago|
Platform:
Work from Office
Full Time
• Reviewing and investigating claims processing, verifying the proper payment of claims, and bringing insurance claims to full resolution through a combination of external third-party relationships and cross-functional communication and collaboration.• Maintaining service level agreements regarding assigned accounts receivable tasks while ensuring timely resolution of all claims while prioritizing responsibilities, problem solving, and thinking critically as you perform your regular duties and accommodate other time sensitive tasks as they arise.• Conducts regular review and follow up of accounts receivables, ensuring the timely resolution and payment of accounts. Utilizing multiple reports and worklists, ensuring that all claims are adjudicated correctly per the member's benefits, investigating claims that do not process as expected or for which we do not receive a determination, all while adhering to all applicable guidelines.• Design, develop, and implement process improvements to prevent denials and reduce internal processing errors.• Develop resource material that is accessible and shared by the team and assist in the development of training materials for denial management. Assist in the training of new hires in AR• Finding and resolving market trends with specific payors, escalating where appropriate while utilizing root cause analysis to develop appropriate action plans.• Omission of specific duties does not exclude them from this position if the work is similar, related or a logical assignment for this position
- Bachelor's degree in accounting and commerce (B. Com)
- • Minimum experience of 4 years in Insurance Accounts Receivable in RCM space required- • Experience working in shared services environment with productivity targets- • Exposure to US healthcare and insurance landscape- • Experience with Medicare preferred- • Exceptional communication and interpersonal skills- • A proven track record of seeing projects through to completion, thorough follow through, and an ability to work independently with a strong attention to detail- • Proven ability to solve complex problems- • Driven to ask questions and find solutions- • Understanding of basic accounting principles and receivables management- • Proven ability to adhere to policies and procedures, as defined by leadership
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