5 Payer Portals Jobs

Inviting applications for the role of Management Trainee, Accounts Receivable (AR) Specialist - RCM (Revenue Cycle Management) We are looking for a proactive and passionate Accounts Receivable (AR) Specialist with some years of hands-on experience in the US healthcare AR process within a healthcare BPO or outsourcing setup. The ideal candidate should be confident in working denials and unpaid claims, speaking with payors to resolve issues, and driving resolution for timely reimbursements. This role demands strong analytical skills, clear communication, and a goal-driven mindset. Responsibilities Review and analyze outstanding Accounts Receivable reports to identify unpaid claims. Initiate follow-ups with insurance companies (via phone calls and portals) to check claim status and resolve denials or underpayments. Document all actions taken on claims accurately in the client's billing system. Understand and interpret EOBs, remittance advices , and payer correspondences . Work on claim re-submissions, appeals, and corrective actions as needed. Meet or exceed daily/weekly productivity and quality targets. Stay current with payer policies, coding guidelines, and RCM best practices. Qualifications we seek in you! Minimum Qualifications / Skills Any Graduate Preferred Qualifications/ Skills Experience in US healthcare Accounts Receivable/AR follow-up. Prior experience with a US healthcare outsourcing company or BPO is mandatory . Strong knowledge of insurance denials, appeals, CPT/ICD codes, and healthcare billing concepts. Excellent verbal and written communication skills must be comfortable speaking directly with payors. Strong analytical, investigative, and problem-solving abilities. Proficient in using billing software, payer portals, and productivity tracking tools. Passionate about healthcare revenue operations and delivering results. Growth-oriented with a continuous improvement mindset. Dependable team player with the ability to work independently when needed. Prior experience with billing platforms like Athena, Kareo , or AdvancedMD is a plus. Work Environment Operate within a structured framework but is you are expected to be proactive and analytically independent in your own area of responsibility Employment Type: Full-Time Shift: [US Shift/Night Shift EST/EDT hours]

At Commure, our mission is to simplify healthcare. We have bold ambitions to reimagine the healthcare experience, setting a new standard for how care is delivered and experienced across the industry. Our growing suite of AI solutions spans ambient AI clinical documentation, provider copilots, autonomous coding, revenue cycle management and more all designed for providers & administrators to focus on what matters most: providing care. Healthcare is a $4.5 trillion industry with more than $500 billion spent annually on administrative costs, and Commure is at the heart of transforming it. We power over 500,000 clinicians across hundreds of care sites nationwide more than $10 billion flows through our systems and we support over 100 million patient interactions. With new product launches on the horizon, expansion into additional care segments, and a bold vision to tackle healthcare&aposs most pressing challenges, our ambition is to move from upstart innovator to the industry standard over the next few years. Backed by world-class investors including General Catalyst, Sequoia, Y Combinator, Lux, Human Capital, 8VC, Greenoaks Capital, Elad Gil, and more, Commure has achieved over 300% year-over-year growth for the past two years and this is only the beginning. Healthcare&aposs moment for AI-powered transformation is here, and we&aposre building the technology to power it. Come join us in shaping the future of healthcare. Role Overview The Assistant Manager (Appeals) will be responsible for overseeing the Appeals process in the RCM function, ensuring timely and accurate resolution of denied claims. This role requires hands-on expertise in handling both Inpatient and Outpatient Appeals, with the ability to manage a team of taskers, monitor performance, and drive operational efficiency. The candidate must demonstrate strong analytical, problem-solving, and communication skills to collaborate with payers, clients, and internal stakeholders. Key Responsibilities Supervise day-to-day Appeals operations and ensure SLA adherence for Inpatient and Outpatient claims. Review and analyse denied claims, identifying root causes and ensuring effective appeal strategies. Manage a team of Appeals taskers, providing guidance, coaching, and performance feedback. Ensure appeals are drafted and submitted with accurate clinical and administrative justification. Monitor productivity and quality benchmarks; implement corrective actions where needed. Act as an escalation point for complex appeal cases requiring advanced expertise. Track key metrics (turnaround time, success rate, appeal overturn percentage) and report performance to leadership. Contribute to process improvements and automation initiatives to enhance efficiency and accuracy. Required Qualifications 57 years of RCM experience, with at least 23 years in Appeals. Strong exposure to both Inpatient and Outpatient Appeals is mandatory. Proven experience in managing or leading a team in the RCM domain. Strong analytical, problem-solving, and decision-making abilities. Excellent communication skills (verbal and written) to coordinate with clients and internal teams. Preferred Skills Prior experience as a Team Lead/Assistant Manager in Appeals within a US RCM company. Proficiency with RCM tools, EMR/EHR systems, and payer portals. Ability to manage high-volume workflows and prioritise under pressure. Commure + Athelas is committed to creating and fostering a diverse team. We are open to all backgrounds and levels of experience, and believe that great people can always find a place. We are committed to providing reasonable accommodations to all applicants throughout the application process. Please be aware that all official communication from us will come exclusively from email addresses ending in @ getathelas.com , @ commure.com or @ augmedix.com . Any emails from other domains are not affiliated with our organization. Employees will act in accordance with the organizations information security policies, to include but not limited to protecting assets from unauthorized access, disclosure, modification, destruction or interference nor execute particular security processes or activities. Employees will report to the information security office any confirmed or potential events or other risks to the organization. Employees will be required to attest to these requirements upon hire and on an annual basis. Show more Show less

Job Title: Prior Authorization Team Lead Location: Kondapur, Hyderabad - ONSITE Shift Timing: U.S. Time Zone - Indian night shifts Department: Revenue Cycle / Prior Authorization We appreciate the value of your time as well as ours, so please review the entire job description and apply only if you are interested. At Staffingly, Inc., we are at the forefront of revolutionizing healthcare operations by providing essential services to doctors, laboratories, pharmacies, and other healthcare providers. As a leader in economic Prior Authorization solutions, we tackle the challenges of staff shortages that impact revenue flow and patient care quality. Our mission is to empower healthcare facilities to focus on what truly matters, exceptional patient care by simplifying and streamlining their administrative processes. Our comprehensive service offerings include handling intricate Prior Authorization processes, accurate insurance verifications, expert management of medication and procedural authorizations, full-spectrum Revenue Cycle Management (RCM), Medical Billing/Coding, Data Entry, and Customer Support services. With 24/7 operations, we ensure efficiency and responsiveness, supporting our clients in maintaining smooth and effective healthcare delivery. If youre passionate about making a meaningful impact in the healthcare industry by improving operational efficiencies and enhancing patient care, Staffingly, Inc. is the place for you. We are eager to see how your skills and expertise can contribute to our growth and success. For more information, visit us at https://staffingly.com Join Our META Verified WhatsApp Channel for Healthcare BPO/KPO Jobs! https://bit.ly/bpo-whatsapp-jobs Please share with friends Position Summary: ? The Prior Authorization Team Lead will oversee and coordinate the daily operations of the prior authorization team, ensuring timely and accurate processing of prior authorizations, eligibility verification, and benefits verification. The ideal candidate will have in-depth knowledge of cardiology, radiology, orthopaedics , and medication prior authorization workflows . This role requires strong leadership, payer policy knowledge, and the ability to coach team members to meet productivity and quality standards. Key Responsibilities: Team Leadership & Oversight Supervise, train, and mentor prior authorization staff. Monitor workload distribution and ensure timely completion of all authorization requests. Provide performance feedback, coaching, and training to enhance staff knowledge and efficiency. Prior Authorization Processing Review and process prior authorization requests for cardiology, radiology, orthopaedics, and medications in compliance with payer guidelines. Ensure all necessary clinical documentation is complete for submission. Serve as a subject matter expert for specialty-specific prior authorizations. Eligibility & Benefits Verification Oversee teams verification of patient eligibility and insurance benefits prior to scheduling services. Interpret payer benefit coverage, limitations, co-payments, deductibles, and out-of-pocket costs. Escalate and resolve complex coverage or benefit disputes. Compliance & Quality Ensure compliance with HIPAA, payer guidelines, and internal policies. Monitor and maintain quality assurance metrics and audit results. Stay current with payer requirements, coding updates, and industry best practices. Collaboration Work closely with providers, schedulers, and billing teams to ensure accurate authorization and verification workflows. Communicate with insurance companies to expedite authorization decisions and resolve issues. Act as the liaison between clinical staff and payers for complex or urgent cases. Qualifications & Skills: Required: Minimum 6 - 12 years of prior authorization experience, with at least 12 years in a lead or supervisory role . Strong working knowledge in speciality & Modalities (ophthalmologist, Oncology, Pain Management etc..) Proficiency in eligibility and benefits verification using payer portals and clearinghouse tools. Strong understanding of insurance payer guidelines, CPT/HCPCS/ICD-10 codes. Excellent communication, leadership, and problem-solving skills. Ability to work in a fast-paced environment and manage competing priorities. Preferred: Experience with EHR systems (Cerner, Athena, Allscripts, or similar). Familiarity with Medicare, Medicaid, and commercial insurance plans. Benefits: Provident Fund contributions. Overtime and holiday pay. On-site benefits, including travel allowances and meals. Referral and birthday bonuses. Night shift allowances. Recognition through our "Employee of the Month" program. Show more Show less

Position Summary... What you&aposll do... Position: Operations Manager Accounts Receivable (AR) Location: Chennai Company: Walmart Global Tech Industry: Healthcare Revenue Cycle Management / BPO Employment Type: Full- ???? Role Objective Job summary: Join Walmart&aposs dynamic Health & Wellness Operations Team as an associate and play a key role in driving the operational excellence and growth of our healthcare services. In this position, you will oversee and optimize the daily operations of our Health & Wellness division, ensuring seamless integration of retail and clinical services Walmart has their Own Pharmacy in which they deal with Optical, Vision & Dental care. About Team: We have a team of total 55 associate, 45 in USA + 10 in India at this point and we have plan to expand the team in India, Chennai. We offer our expertise in Coding, Account receivable, Cash Posting & Ancillary business (backend operations). ???? What You&aposll Do... Team Leadership & Performance Management: Manage a team of 5080 Full-Time Equivalents (FTEs), including work allocation, performance reviews, and training initiatives. Implement productivity and quality benchmarks, conduct regular one-on-one sessions, and oversee Performance Improvement Plans (PIPs). Operational Oversight: Ensure adherence to departmental policies and procedures in line with corporate standards. Monitor and manage key performance indicators (KPIs) such as Days in AR, Unposted Cash, and denial rates. Client Interaction & Escalation Management: Serve as the primary point of contact for client communications, handling escalations and ensuring client satisfaction. Participate in client calls, providing updates on performance metrics and addressing concerns proactively. Reporting & Analysis: Generate and analyze internal and client-facing reports, identifying trends and areas for improvement. Utilize tools like MS Excel to prepare daily, weekly, and monthly operational metrics reports. Process Improvement: Identify opportunities for process enhancements using methodologies like Lean Six Sigma. Collaborate with cross-functional teams to implement automation and efficiency initiatives. Compliance & Quality Assurance: Ensure compliance with healthcare regulations, including Medicare and Medicaid guidelines. Maintain thorough knowledge of CMS 1500 & UB04 forms, ICD & CPT codes, and payer-specific requirements. What You&aposll Bring... Education: Graduate in any discipline from a recognized educational institute. Experience: Minimum of 10 years in billing and AR follow-up within a hospital or healthcare environment. At least 2 years in a supervisory or leadership role. Technical Skills: Proficiency in MS Word, Excel, PowerPoint, and Outlook. Familiarity with medical billing software and payer portals. Communication: Excellent written and verbal communication skills. Skills: Strong analytical and problem-solving abilities. Ability to work independently and collaboratively in a fast-paced environment. Demonstrated leadership qualities and decision-making capabilities. ???? Work Environment Shift: Open to night shifts to align with US client operations. Work Setup: Willingness to work in a Work-From-Office (WFO) setup. Location Flexibility: Chennai only About Walmart Global Tech Imagine working in an environment where one line of code can make life easier for hundreds of millions of people. Thats what we do at Walmart Global Tech. Were a team of software engineers, data scientists, cybersecurity expert&aposs and service professionals within the worlds leading retailer who make an epic impact and are at the forefront of the next retail disruption. People are why we innovate, and people power our innovations. We are people-led and tech-empowered. We train our team in the skillsets of the future and bring in experts like you to help us grow. We have roles for those chasing their first opportunity as well as those looking for the opportunity that will define their career. Here, you can kickstart a great career in tech, gain new skills and experience for virtually every industry, or leverage your expertise to innovate at scale, impact millions and reimagine the future of retail. Flexible, hybrid work We use a hybrid way of working with primary in office presence coupled with an optimal mix of virtual presence. We use our campuses to collaborate and be together in person, as business needs require and for development and networking opportunities. This approach helps us make quicker decisions, remove location barriers across our global team, be more flexible in our personal lives. Benefits Beyond our great compensation package, you can receive incentive awards for your performance. Other great perks include a host of best-in-class benefits maternity and parental leave, PTO, health benefits, and much more. Belonging We aim to create a culture where every associate feels valued for who they are, rooted in respect for the individual. Our goal is to foster a sense of belonging, to create opportunities for all our associates, customers and suppliers, and to be a Walmart for everyone. At Walmart, our vision is "everyone included." By fostering a workplace culture where everyone isand feelsincluded, everyone wins. Our associates and customers reflect the makeup of all 19 countries where we operate. By making Walmart a welcoming place where all people feel like they belong, were able to engage associates, strengthen our business, improve our ability to serve customers, and support the communities where we operate. Equal Opportunity Employer Walmart, Inc., is an Equal Opportunities Employer By Choice. We believe we are best equipped to help our associates, customers and the communities we serve live better when we really know them. That means understanding, respecting and valuing unique styles, experiences, identities, ideas and opinions while being inclusive of all people. Minimum Qualifications... Outlined below are the required minimum qualifications for this position. If none are listed, there are no minimum qualifications. Option 1: Bachelor&aposs degree in accounting, finance, information technology, business, or related area and 1 year&aposs experience in accounting, finance, information technology, business, or related area. Option 2: 3 years' experience in accounting, finance, information technology, or related area. Preferred Qualifications... Outlined below are the optional preferred qualifications for this position. If none are listed, there are no preferred qualifications. 1 years experience leading cross-functional teams., Master&aposs degree in accounting, finance, information technology, business, or related area. Primary Location... Rmz Millenia Business Park, No 143, Campus 1B (1St -6Th Floor), Dr. Mgr Road, (North Veeranam Salai) Perungudi , India R-2237205 Show more Show less

Ready to shape the future of work At Genpact, we don&rsquot just adapt to change&mdashwe drive it. AI and digital innovation are redefining industries, and we&rsquore leading the charge. Genpact&rsquos , our industry-first accelerator, is an example of how we&rsquore scaling advanced technology solutions to help global enterprises work smarter, grow faster, and transform at scale. From large-scale models to , our breakthrough solutions tackle companies most complex challenges. If you thrive in a fast-moving, tech-driven environment, love solving real-world problems, and want to be part of a team that&rsquos shaping the future, this is your moment. Genpact (NYSE: G) is an advanced technology services and solutions company that delivers lasting value for leading enterprises globally. Through our deep business knowledge, operational excellence, and cutting-edge solutions - we help companies across industries get ahead and stay ahead. Powered by curiosity, courage, and innovation , our teams implement data, technology, and AI to create tomorrow, today. Get to know us at and on , , , and . Inviting applications for the role of Management Trainee , Accounts Receivable (AR) Specialist - RCM (Revenue Cycle Management) We are looking for a proactive and passionate Accounts Receivable (AR) Specialist with some years of hands-on experience in the US healthcare AR process within a healthcare BPO or outsourcing setup. The ideal candidate should be confident in working denials and unpaid claims, speaking with payors to resolve issues, and driving resolution for timely reimbursements. This role demands strong analytical skills, clear communication, and a goal-driven mindset. Responsibilities Review and analyze outstanding Accounts Receivable reports to identify unpaid claims. Initiate follow-ups with insurance companies (via phone calls and portals) to check claim status and resolve denials or underpayments. Document all actions taken on claims accurately in the client&rsquos billing system. Understand and interpret EOBs, remittance advices , and payer correspondences . Work on claim re-submissions, appeals, and corrective actions as needed. Meet or exceed daily/weekly productivity and quality targets. Stay current with payer policies, coding guidelines, and RCM best practices. Preferred Q ualifications / Skills E xperience in US healthcare Accounts Receivable/AR follow-up. Prior experience with a US healthcare outsourcing company or BPO is mandatory . Strong knowledge of insurance denials, appeals, CPT/ICD codes, and healthcare billing concepts. Excellent verbal and written communication skills must be comfortable speaking directly with payors. Strong analytical, investigative, and problem-solving abilities. Proficient in using billing software, payer portals, and productivity tracking tools. Passionate about healthcare revenue operations and delivering results. Growth-oriented with a continuous improvement mindset. Dependable team player with the ability to work independently when needed. Prior experience with billing platforms like Athena, Kareo , or AdvancedMD is a plus. Work Environment Operate within a structured framework but is you are expected to be proactive and analytically independent in your own area of responsibility Employment Type: Full-Time Shift: [US Shift/Night Shift EST/EDT hours] Why join Genpact Be a transformation leader - Work at the cutting edge of AI, automation, and digital innovation Make an impact - Drive change for global enterprises and solve business challenges that matter Accelerate your career - Get hands-on experience, mentorship, and continuous learning opportunities Work with the best - Join 140,000+ bold thinkers and problem-solvers who push boundaries every day Thrive in a values-driven culture - Our courage, curiosity, and incisiveness - built on a foundation of integrity and inclusion - allow your ideas to fuel progress Come join the tech shapers and growth makers at Genpact and take your career in the only direction that matters: Up. Let&rsquos build tomorrow together. Genpact is an Equal Opportunity Employer and considers applicants for all positions without regard to race, color, religion or belief, sex, age, national origin, citizenship status, marital status, military/veteran status, genetic information, sexual orientation, gender identity, physical or mental disability or any other characteristic protected by applicable laws. Genpact is committed to creating a dynamic work environment that values respect and integrity, customer focus, and innovation. Furthermore, please do note that Genpact does not charge fees to process job applications and applicants are not required to pay to participate in our hiring process in any other way. Examples of such scams include purchasing a %27starter kit,%27 paying to apply, or purchasing equipment or training.