RCM AR Analyst

About the Company

EMPClaims has been recognized as a Top 10 vendor for RCM Services in the US, and we take pride in the quality of our services. Our customers include large health systems and small medical practices.

We offer you a competitive compensation package along with the opportunity to learn on the job, develop knowledge of the process, and grow your career. We are committed to providing exceptional service and support to our clients, fostering a culture of collaboration and innovation.

About the Role

The role involves reviewing claim statuses, communicating effectively with clients, and evaluating clinical documentation to ensure compliance with patient claim plans.

Responsibilities

• Examine Denials resulting from non-compliance to Payor billing requirements, work
• with the Payor to find a resolution, and implement the correction by escalating to
• Leadership
• Review 120+ AR for collection feasibility and determine adjustments required
• Propose process improvements to address repeated issues or trends
• Apply knowledge of insurance billing information including modifiers, authorization
• criteria, CPT, ICD-10 coding and payor specific requirements
• Maintain communication with Payors regarding changes to policies and procedures and
• communicate the same to Leadership
• Support the development and maintenance of Payor performance metrics (Denial Rate by
• payor, Gross Collection Rate by payor etc)
• Maintain the First Pass resolution rate for practices at 90% or above
• Always maintain the aging of Client Review AR bucket at less than 10% for 120+ and
• less than 20% for 90+ AR

Qualifications

• Excellent verbal & written communication & listening skills
• Requires working knowledge of MS Office (Excel, Word)
• Good Understanding of the US accent
• Should be open for fixed night shift (06:00 PM to 03:00 AM)

Required Skills

• Must be detail oriented, organized, and possess the ability to apply critical thinking skills.
• Must be proficient with the usage of Microsoft Office 365, especially MS Excel for Data
• Analysis and MS PowerPoint for presenting analyzed data
• Physician - Medical Billing experience - 3 years minimum
• Excellent communication skills and assertiveness to escalate and dispute issues with
• payors and communicate the trends to Leadership

Preferred Skills

• Experience in a similar role is a plus
• Ability to work under pressure

Perks and Benefits

• Lucrative Incentive Plans
• Subsidized Meals
• Leave encashment
• Provident Fund/ ESIC
• Night Shift Allowance
• Career growth opportunities
• Fixed Shift

Equal Opportunity Statement

We are an equal opportunity employer and are committed to creating a diverse and inclusive workplace.

careers@empclaims.com

9016441882