Provide Tier 1 and Tier 2 support to the US doctors and Clinical staff. Receive, analyze, and process the requests submitted via e-mail, Cases, and voice mails, inbound calls. Trouble shoot the errors on the EMR application. Assist Clinical staff and physicians with the workflow issues. Ability to deal with problems involving several variables in both standard and unusual situations. Coordinate with internal teams in order fix the issues in a timely manner.
Create and Execute manual test cases and document results. Identify, report, and track bugs and defects. Validate UI, functionality, and performance for the software across different platforms. Collaborate with developers and QA teams to ensure test coverage. Create test scripts in Java or Python using automation tools
Primary Functions 1. Payment Processing & Posting Post payments from insurance companies, government programs (Medicare/Medicaid), and patients into the RCM system. Process Electronic Remittance Advices (ERA) and manual Explanation of Benefits (EOB). • Apply necessary adjustments, refunds, and write-offs per payer guidelines. • Balance and reconcile daily deposits with posted payments. 2. Denial Management & Reconciliation • Identify and post insurance denials while ensuring timely follow-up for resolution. • Work with the billing and accounts receivable teams to correct claim errors and resubmit claims. Track underpayments and escalate discrepancies to the RCM Manager. 3. Reporting & Documentation Maintain accurate payment records and reconciliation reports. Generate daily, weekly, and monthly reports on payment trends, denials, and discrepancies. Ensure compliance with company policies and industry regulations (HIPAA, Medicare guidelines). 4. Communication & Collaboration Coordinate with the billing team, accounts receivable, and insurance companies to resolve payment discrepancies. Respond to inquiries from internal teams regarding posted payments. Escalate unresolved payment issues to the appropriate leadership. Job Qualifications: Minimum Qualifications: 1. Bachelor’s degree in Accounting, Finance, Business Administration, or a related field (preferred). 2. 1-3 years of experience in medical billing, payment posting, or revenue cycle management. 3. Experience working with RCM software (e.g., EPIC, eClinicalWorks, NextGen, Athenahealth,Kareo or Cerner 4. Strong understanding of insurance reimbursement, medical billing, and denial management. 5. Proficiency in MS Excel, accounting principles, and payment reconciliation. 6. Knowledge of HIPAA regulations and compliance standards. Shift time 8am to 5pm Work mode- Office
Primary Functions: Payment Processing & Posting Accurately post payments received from insurance companies, government programs (such as Medicare/Medicaid), and patients into the Revenue Cycle Management (RCM) system. Efficiently process Electronic Remittance Advices (ERAs) and manual Explanation of Benefits (EOBs). Apply necessary adjustments, refunds, and write-offs in accordance with payer guidelines. Balance and reconcile daily deposits with posted payments to ensure accuracy. Denial Management & Reconciliation Identify and accurately post insurance denials, ensuring timely follow-up for resolution. Collaborate with the billing and accounts receivable teams to correct claim errors and facilitate claim resubmissions. Track underpayments and escalate discrepancies to the RCM Manager for further action. Reporting & Documentation Maintain precise payment records and reconciliation reports. Generate daily, weekly, and monthly reports on payment trends, denials, and discrepancies. Ensure strict compliance with company policies and industry regulations, including HIPAA and Medicare guidelines Communication & Collaboration Coordinate effectively with the billing team, accounts receivable, and insurance companies to resolve payment discrepancies. Respond promptly to inquiries from internal teams regarding posted payments. Escalate unresolved payment issues to the appropriate leadership as needed. Additional Job Description: Any bachelor’s degree. Good Communication Skills (Written and Verbal). 1-3 years of proven experience in payment posting within a healthcare environment is essential Strong understanding of healthcare revenue cycle management (RCM) processes. Proficiency in interpreting Electronic Remittance Advices (ERAs) and Explanation of Benefits (EOBs) with healthcare-specific knowledge. Experience with healthcare-specific RCM software (e.g., Epic, Cerner, NextGen, Athenahealth, Kareo, or similar). Soft/Behavioral Skills: Problem-Solver: Identifies and resolves healthcare billing discrepancies. Organized: Manages high volumes of medical remittances efficiently. Clear Communicator: Effectively discusses payment issues with healthcare teams. Analytical: Understands healthcare financial data and denial patterns. Shift Timing: Day Shift (8am to 5pm IST)/ Work Mode: Work from Office-Mumbai
Primary Functions: Payment Processing & Posting Accurately post payments received from insurance companies, government programs (such as Medicare/Medicaid), and patients into the Revenue Cycle Management (RCM) system. Efficiently process Electronic Remittance Advices (ERAs) and manual Explanation of Benefits (EOBs). Apply necessary adjustments, refunds, and write-offs in accordance with payer guidelines. Balance and reconcile daily deposits with posted payments to ensure accuracy. Denial Management & Reconciliation Identify and accurately post insurance denials, ensuring timely follow-up for resolution. Collaborate with the billing and accounts receivable teams to correct claim errors and facilitate claim resubmissions. Track underpayments and escalate discrepancies to the RCM Manager for further action. Reporting & Documentation Maintain precise payment records and reconciliation reports. Generate daily, weekly, and monthly reports on payment trends, denials, and discrepancies. Ensure strict compliance with company policies and industry regulations, including HIPAA and Medicare guidelines Communication & Collaboration Coordinate effectively with the billing team, accounts receivable, and insurance companies to resolve payment discrepancies. Respond promptly to inquiries from internal teams regarding posted payments. Escalate unresolved payment issues to the appropriate leadership as needed. Additional Job Description: Any bachelor’s degree. Good Communication Skills (Written and Verbal). 1-3 years of proven experience in payment posting within a healthcare environment is essential Strong understanding of healthcare revenue cycle management (RCM) processes. Proficiency in interpreting Electronic Remittance Advices (ERAs) and Explanation of Benefits (EOBs) with healthcare-specific knowledge. Experience with healthcare-specific RCM software (e.g., Epic, Cerner, NextGen, Athenahealth, Kareo, or similar). Soft/Behavioral Skills: Problem-Solver: Identifies and resolves healthcare billing discrepancies. Organized: Manages high volumes of medical remittances efficiently. Clear Communicator: Effectively discusses payment issues with healthcare teams. Analytical: Understands healthcare financial data and denial patterns. Shift Timing: Day Shift (8am to 5pm IST)/ Work Mode: Work from Office-Mumbai
Primary Functions: Payment Processing & Posting Accurately post payments received from insurance companies, government programs (such as Medicare/Medicaid), and patients into the Revenue Cycle Management (RCM) system. Efficiently process Electronic Remittance Advices (ERAs) and manual Explanation of Benefits (EOBs). Apply necessary adjustments, refunds, and write-offs in accordance with payer guidelines. Balance and reconcile daily deposits with posted payments to ensure accuracy. Denial Management & Reconciliation Identify and accurately post insurance denials, ensuring timely follow-up for resolution. Collaborate with the billing and accounts receivable teams to correct claim errors and facilitate claim resubmissions. Track underpayments and escalate discrepancies to the RCM Manager for further action. Reporting & Documentation Maintain precise payment records and reconciliation reports. Generate daily, weekly, and monthly reports on payment trends, denials, and discrepancies. Ensure strict compliance with company policies and industry regulations, including HIPAA and Medicare guidelines. Communication & Collaboration Coordinate effectively with the billing team, accounts receivable, and insurance companies to resolve payment discrepancies. Respond promptly to inquiries from internal teams regarding posted payments. Additional Job Description: Any bachelor’s degree. Good Communication Skills (Written and Verbal). 1-3 years of proven experience in payment posting within a healthcare environment is essential Strong understanding of healthcare revenue cycle management (RCM) processes. Proficiency in interpreting Electronic Remittance Advices (ERAs) and Explanation of Benefits (EOBs) with healthcare-specific knowledge. Experience with healthcare-specific RCM software (e.g., Epic, Cerner, NextGen, Athenahealth, Kareo, or similar). Soft/Behavioral Skills: Problem-Solver: Identifies and resolves healthcare billing discrepancies. Organized: Manages high volumes of medical remittances efficiently. Clear Communicator: Effectively discusses payment issues with healthcare teams. Analytical: Understands healthcare financial data and denial patterns. Shift Timing: Day Shift (8am to 5pm IST) Work from Office- Mumbai
Bizmatics, A leading EHR company provides clinical and business productivity software and services to medical practices & multi-specialties. Our cloud-based application, PrognoCIS is a fully-integrated solution comprising EHR, Telemedicine, Practice Management, Medical Billing, RCM, Patient Engagement tools, and more. Built on multi-tier Internet architecture, PrognoCIS EHR supports all major specialties and has fully customizable templates. The integrated architecture supports common databases for all Prognocis products to ensure seamless, real-time information flow between EHR and Billing. PrognoCIS is available both as an ASP service or an in-house Client-Server solution. As a Quality Assurance Analyst, this professional will be responsible for ensuring the quality and reliability of our software applications through comprehensive testing processes. You will collaborate closely with cross-functional teams, including developers, product managers, and project managers, to drive the success of our products. Work Mode: Hybrid Shift Timings: 9:30AM to 6:30PM IST Location: Mumbai, Nagpur Responsibilities & Duties: 1. Analyze software requirements and technical specifications. 2. Participate in requirement and design review meetings. 3. Develop and documents application test plans based on business requirements and technical specifications. 4. Create test cases including detailed expected results. What we are looking for: 1. Bachelor’s degree in Computer Science, Software Engineering, a related field, or relevant experience. 2. 1+ year(s) of experience in software quality assurance or software testing. 3. Hands-on experience in manual testing and familiarity with automated testing tools. 4. Proven understanding of QA processes, methodologies, and testing types
Hiring Manager: Lenson Fernandes Business Unit: Resolv Job Title: Payment Associate Header: Here at Harris, we have 5 different business verticals, Public Sector, Healthcare, Utilities, Insurance and Private sector, with over 12,000 employees and more than 100,000 customers located in 200 countries around the globe. We need your help to keep growing and we hope you can become an integral part of the Harris family. BU: Resolv has revenue cycle solution brands in our DNA. We formed in 2022, bringing together a suite of industry-leading healthcare revenue cycle leaders with more than 30 years of industry expertise—including Ultimate Billing, First Pacific Corporation, Innovative Healthcare Systems, and Innovative Medical Management. As we continue to expand, we remain dedicated to partnering with RCM companies that offer a variety of solutions and address today’s most pressing healthcare reimbursement and revenue cycle operations complexities. Together, we will improve financial performance and patient experience and help build sustainable healthcare businesses. Job Summary: The Payment Posting Associate is responsible for accurately and efficiently posting payments, adjustments, and denials from various payers. The role is critical in ensuring the financial integrity of the organization by reconciling deposits, identifying discrepancies, and collaborating with the billing team to resolve payment-related Issues. Primary Functions: 1. Payment Processing & Posting Post payments from insurance companies, government programs (Medicare/Medicaid), and patients into the RCM system. Process Electronic Remittance Advices (ERA) and manual Explanation of Benefits (EOB). • Apply necessary adjustments, refunds, and write-offs per payer guidelines. • Balance and reconcile daily deposits with posted payments. 2. Denial Management & Reconciliation • Identify and post insurance denials while ensuring timely follow-up for resolution. • Work with the billing and accounts receivable teams to correct claim errors and resubmit claims. Track underpayments and escalate discrepancies to the RCM Manager. 3. Reporting & Documentation Maintain accurate payment records and reconciliation reports. Generate daily, weekly, and monthly reports on payment trends, denials, and discrepancies. Ensure compliance with company policies and industry regulations (HIPAA, Medicare guidelines). 4. Communication & Collaboration Coordinate with the billing team, accounts receivable, and insurance companies to resolve payment discrepancies. Respond to inquiries from internal teams regarding posted payments. Escalate unresolved payment issues to the appropriate leadership. Job Qualifications: 1. Bachelor’s degree in accounting, Finance, Business Administration, or a related field (preferred). 2. 1-3 years of experience in medical billing, payment posting, or revenue cycle management. 3. Experience working with RCM software (e.g., EPIC, eClinicalWorks, NextGen, Athenahealth,Kareo or Cerner 4. Strong understanding of insurance reimbursement, medical billing, and denial management. 5. Proficiency in MS Excel, accounting principles, and payment reconciliation. 6. Knowledge of HIPAA regulations and compliance standards. Additional Qualifications(Good to Have): Any diploma or Higher Degree. Soft/ Behavior Skills: Good Communication and Collaboration. Strong ARO Ability to work both independently and as part of a team Strong analytical and creative problem-solving skills The above statements are intended to describe the general nature and level of work being performed by people assigned to this job. It is not designed to be utilized as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this job. Working Environment: This job operates in a professional office environment or remote home office location. This role routinely uses standard office equipment such as computers, laptops and other stuffs. This role may occasionally encounter Protected Health Information, Personal Identifiable Information or Privacy Records, and it is essential that all employees adhere to confidentiality requirements as outlined in the Employee Handbook and Harris’ Security and Privacy policies, as well as apply the concepts learned in the annual Security Awareness training. Expected Hours of Work: 8am to 5pm IST. Work Mode: Work from Office.
Business Unit: Resolv was formed in 2022, bringing together a suite of industry-leading healthcare revenue cycle leaders with over 30 years of industry expertise, including Ultimate Billing, First Pacific Corporation, Innovative Healthcare Systems, and Innovative Medical Management. Our DNA is rooted in revenue cycle solutions. As we continue to expand, we remain dedicated to partnering with RCM companies that offer diverse solutions and address today's most pressing healthcare reimbursement and revenue cycle operations complexities. Together, we improve financial performance and patient experience, helping to build sustainable healthcare businesses. Job Summary: Responsible for managing prior authorizations and referrals, including verifying insurance eligibility, reviewing clinical data, and ensuring timely approvals. Must demonstrate accuracy (95%+), critical thinking, problem-solving, and the ability to multitask in a fast-paced, team-oriented environment while maintaining compliance with client workflows. Work Mode: Remote Shift Timings: 6pm to 3am (Night Shift) Location: Mumbai Primary Functions: Verify patient insurance coverage and eligibility. Identify and complete the correct prior authorization form required for each payer. Assist in the initiation of new prior authorization/referrals. Review clinical data against specified medical criteria for authorization. Review incoming orders for completeness to determine if an authorization will be approved. Monitor client schedules for upcoming appointments to ensure timely approvals. Follow up on pending requests and maintain proper tracking until closure. Utilize payer portals to submit and monitor authorizations. Coordinate Peer-to-Peer reviews when necessary. Communicate with insurance providers daily to obtain and confirm authorizations. Ensure compliance with client workflows, payer protocols, and company standards. Meet departmental production standards and accuracy benchmarks consistently. Identify issues and escalate to management when required. Support the team approach by assisting colleagues and sharing best practices. Train new staff members when assigned. Perform additional duties as assigned. (Mandatory Qualifications & Skills): Bachelor’s degree (in any stream). At least 6 months to 1 year of relevant experience in Pre-authorization, Verification, or Accounts Receivable (AR). Strong attention to detail with the ability to work in a fast-paced environment. Proficiency in multitasking and meeting accuracy standards (95%+). Effective written and verbal communication skills. Knowledge of CPT Codes and ICD-10. Knowledge of clinical documentation required for authorizations/referrals. Awareness of retro-authorization timelines. Understanding of differences between referrals and authorizations. What Would Make You Stand Out: (Preferred/Good-to-Have Skills) Prior Authorization experience in Drugs and Radiology. Familiarity with revenue cycle processes. Accounts Receivable experience. Ability to work independently while collaborating effectively in a team. Skills/ Behavioural Skills: Problem-Solver: Identifies and resolves healthcare billing discrepancies. Organized: Manages high volumes of medical remittances efficiently. Clear Communicator: Effectively discusses payment issues with healthcare teams. Analytical: Understands healthcare financial data and denial patterns. Benefits: Annual Public Holidays as applicable 30 days total leave per calendar year Mediclaim policy Lifestyle Rewards Program Group Term Life Insurance Gratuity ...and more!
Responsibilities & Duties: Analyze software requirements and technical specifications. Participate in requirement and design review meetings. Develop and documents application test plans based on business requirements and technical specifications. Create test cases including detailed expected results. Requirements: Bachelor’s degree in Computer Science, Software Engineering, a related field, or relevant experience. 1+ year(s) of experience in software quality assurance or software testing. Hands-on experience in manual testing and familiarity with automated testing tools. Proven understanding of QA processes, methodologies, and testing types.
Analyzes software requirements and technical specifications. Participates in requirement and design review meetings. Develops and documents application test plans based on business requirements and technical specifications. Creates test cases including detailed expected results. Creates and stages test data. Executes complex functional, application and regression tests. Records and documents results including anomalies and issues. Ensures compliance with general programming best practices, accepted web standards and S&S specific coding standards. Works closely with QA Team members to ensure all software bugs are caught in house before the software is delivered to the customer. Provides timely status reports. Uses a wide variety of software tools including writing SQL queries, running data simulators and verifying data within HTML files. Provides code modification overviews (Maintenance Release Notes) and application testing instructions for users.
Analyzes software requirements and technical specifications. Participates in requirement and design review meetings. Develops and documents application test plans based on business requirements and technical specifications. Creates test cases including detailed expected results. Creates and stages test data. Executes complex functional, application and regression tests. Records and documents results including anomalies and issues. Ensures compliance with general programming best practices, accepted web standards and S&S specific coding standards. Works closely with QA Team members to ensure all software bugs are caught in house before the software is delivered to the customer. Provides timely status reports. Uses a wide variety of software tools including writing SQL queries, running data simulators and verifying data within HTML files. Provides code modification overviews (Maintenance Release Notes) and application testing instructions for users.
What your impact will be KPI Monitoring and Reporting: You will track and report on essential revenue cycle KPIs, including days in AR, denial rates, and overall AR, ensuring that clients are meeting their financial objectives. You will generate reports that provide insights into these KPIs, helping clients make informed decisions. Data-Driven Decision Making: You will analyze client data to identify trends, areas for improvement, and opportunities to optimize revenue cycle processes. Your data analysis will directly contribute to enhancing client outcomes. Client-Centric Solutions: You will anticipate client needs within the context of revenue cycle management and tailor solutions to improve their operational and financial performance. Communication and Problem-Solving: You will effectively communicate findings and insights related to KPI performance to internal teams and clients, while proposing data-driven solutions to address any identified issues. Task Management and Adaptability: You will manage multiple client accounts, prioritizing tasks effectively to meet client deadlines and adapting to varying client needs and challenges. § What we are looking for: Strong Analytical and Problem-Solving Skills: You excel in analyzing revenue cycle data, identifying trends, and solving problems related to KPI performance and revenue cycle processes. Proficiency in Data Analysis Tools: You are proficient in using tools such as Excel, SQL, and Tableau to analyze client data and generate insightful reports that drive decision-making. Understanding of Revenue Cycle Management: You have a basic understanding of healthcare revenue cycle management processes and can apply this knowledge to improve client KPIs and financial outcomes. Excellent Communication and Interpersonal Skills: You are skilled at communicating complex data insights in a clear and concise manner to both internal teams and clients. Attention to Detail: You have a high level of accuracy in managing client data, ensuring that all reports and analyses are thorough and error-free. Ability to Manage Multiple Tasks: You can effectively prioritize and manage multiple tasks, ensuring that all client needs are met in a timely manner.
As a client success manager with the RCM team CSM will be responsible for: Evaluating the clients billing needs. Creating and educating clients on best practice workflow. Responsible for data base set up content in the software to ensure best billing practices workflows. Coordinating all practice billing activities with physician practice and RCM billing teams. Work closely with the Implementation team assigned to ensure proper system build and billing setup. Process clearing house enrollment and assist the physician practice to set up EFT as desired, EDI and ERA enrollment Responsible to set up the client’s system and train staff on using PrognoCIS software based on their workflow using best billing practices. Daily tracking of operational elements of physician practice to include: encounters (open/closed), timely claims processing, timely and accurate payment posting, monitoring of un-posted payments, billing questions, clearinghouse reports, weekly go-live follow up. Establish and maintain a working relationship with physician practice. Proactively analyzes the client’s financial health on a monthly basis to identify reimbursement trends, patterns of denials and to develop an intimate understanding of the factors that are contributing to the clients’ financial performance. Making workflow recommendations to both customer & internal RCM team to improve back office operation. Creation of Month End Reporting and submission to provider practices Research, document & train billing teams on specific insurance, coding and documentation requirements. Research and share billing information pertinent to States and Insurances