Summary: As an AR Executive, you will be responsible for managing accounts receivable by following up with insurance companies to resolve unpaid or denied claims. You will ensure timely collections and help reduce outstanding AR in alignment with revenue cycle goals. Key Responsibilities: Make outbound calls to insurance payers to check claim status and follow up on unpaid or underpaid claims. Investigate claim denials, underpayments, or rejections and take corrective actions including reprocessing or appeals. Interpret Explanation of Benefits (EOBs) and denial codes. Accurately document call notes, actions taken, and claim status in the billing system. Collaborate with team members or client billing departments to resolve complex issues. Achieve daily/weekly productivity and quality benchmarks (calls, resolutions, etc.). Required Skills: Good spoken English and communication skills with a neutral accent. Knowledge of US healthcare terminology (e.g., CPT codes, ICD codes, EOBs). Familiarity with payers such as Medicare, Medicaid, and commercial insurances. Basic understanding of the end-to-end claim lifecycle in US RCM. Proficiency in using payer portals (e.g., Availity) and EHR/RCM software (e.g.,Tebra/Kareo, WeInfuse, Athena, eClinicalWorks, EPIC). Good working knowledge of Microsoft applications such as Outlook, Teams, Excel, Word, and MS PowerPoint. Desired Attributes: Strong problem-solving and analytical skills. Ability to work independently and manage time effectively. Detail-oriented with a focus on accuracy and compliance. A collaborative team player with a commitment to achieving KPIs and collection targets.
Summary: The Eligibility and Benefits Verification Specialist is responsible for confirming patient insurance coverage and benefits prior to medical appointments or procedures. This role ensures accurate verification and pre-authorization processes to prevent billing issues and facilitate a smooth revenue cycle, while assisting patients in understanding their financial responsibilities. Key Responsibilities: Collect and verify patient demographic and insurance information accurately. Confirm insurance eligibility using online payer portals, phone calls, or automated services. Determine detailed benefit information including co-pays, deductibles, coinsurance, and out of-pocket maximums. Obtain and track necessary pre-authorizations or pre-certifications for medical services. Document all verification and authorization communications in the Electronic Health Record (EHR) system. Collaborate with billing, clinical staff, and other departments to resolve insurance discrepancies. Stay updated on insurance policy changes, including managed care and government programs like Medicare. Ensure compliance with HIPAA and maintain strict patient confidentiality. Assist in identifying process improvement opportunities within eligibility verification workflows. Required Skills: Proficiency with EHR software (e.g., Tebra/Kareo, WeInfuse), insurance payer portals. Excellent verbal and written communication skills, with the ability to interact professionally with patients, providers, and insurers. Bilingual skills are a plus. Exceptional attention to detail and organizational skills for accurate data handling. Strong problem-solving skills to address insurance coverage and billing issues effectively. Ability to work independently and collaboratively in a fast-paced environment. Good working knowledge of Microsoft applications such as Outlook, Teams, Excel, Word, and MS PowerPoint. Desired Attributes: High level of professionalism, diplomacy, and composure in sensitive situations. Ability to adapt to policy changes and regulatory requirements. Customer-focused mindset with strong teamwork abilities. Familiarity with healthcare compliance regulations and documentation best practices.
Summary: The Prior Authorization Executive will be responsible for initiating and securing prior authorizations from insurance companies for medical services. This role involves coordinating with clinical teams and payers to ensure services are approved timely, enabling uninterrupted patient care. Key Responsibilities: Initiate and follow up on prior authorization requests for procedures, medications, and services. Communicate with insurance payers via phone, fax, or portals to obtain approvals. Coordinate with physicians, clinical staff, or scheduling teams for required documentation. Use payer portals such as Availity, Navinet, and others to track auth status. Maintain detailed records of all prior authorization requests and outcomes. Update EHR or billing systems with approval, denial, or pending information. Ensure all prior authorizations are processed within the defined turnaround time (TAT). Required Skills: Excellent verbal communication and coordination skills. Familiarity with CPT/HCPCS codes, ICD codes, and payer-specific guidelines. Understanding of medical necessity requirements and pre-auth policies. Experience using insurance portals (e.g., Availity, Navinet) and RCM tools. Ability to multitask and handle high-volume authorization workflows. Good working knowledge of Microsoft applications such as Outlook, Teams, Excel, Word, and MS PowerPoint. Desired Attributes: Strong attention to detail and organizational skills. Ability to work under pressure and meet strict timelines. High level of professionalism and customer service mindset. Familiarity with electronic health records (EHRs) and documentation best practices.
Recruitment & Talent Acquisition Own the end-to-end hiring lifecycle including sourcing, screening, interviewing, and closing candidates across multiple functions. Develop and implement innovative sourcing strategies to attract high-caliber candidates via LinkedIn, job boards, networking, and employee referrals. Conduct structured interviews ensuring a seamless candidate experience and maintain accurate interview documentation. Manage recruitment data, dashboards, and ensure adherence to hiring SLAs. Collaborate with hiring managers to define role requirements and craft effective, compelling job descriptions. Employee Lifecycle Management & HR Operations Oversee the entire employee lifecycle from recruitment to onboarding, engagement, development, and exit processes. Design and implement onboarding programs and skill development initiatives to support employee growth and retention. Drive employee engagement activities, enforce HR policies, and handle grievance resolution. Maintain accurate HR documentation, ensure compliance, and manage employee records effectively. Support performance management cycles and execute core HR initiatives in alignment with organizational goals. Culture, Strategy & Employer Branding Foster a culture of diversity, inclusion, and employee well-being through strategic HR initiatives. Enhance the organizations employer brand through impactful storytelling and targeted branding efforts. Align HR strategies with business objectives, providing data-driven insights to support leadership decision-making. Lead change management and succession planning initiatives to ensure workforce readiness in critical roles. What Were Looking For Minimum 4 years of hands-on recruitment experience; Healthcare/Revenue Cycle Management (RCM) experience preferred but not mandatory. Strong communication, stakeholder management, and multitasking abilities. Proven experience in employee lifecycle management and culture-building initiatives. Ability to thrive in a fast-paced, high-growth environment. A people-first mindset with a strong execution-oriented approach.