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1.0 - 5.0 years
3 - 5 Lacs
Chennai
Work from Office
Dear Candidates, We are hiring for Insurance Verification Executive @ Chennai Process: US RCM Designation: Insurance Verification Executive & Senior Executive Location: Chennai (Guindy) Shift: EST & PST Free Pickup and Drop Available Required Skills Must have exp in US RCM process with end to end process Flexible toward shift timings and weekend support Immediate joiners would be preferred Interested pls share with us your updated resume in watsapp Number: 7397746206 Regards HR Team Qway Technologies
Posted 3 weeks ago
7.0 - 10.0 years
5 - 7 Lacs
Chennai
Work from Office
Dear Candidate's We are Hiring For AR Team Lead @ Chennai location Process: US Healthcare (RCM) Experience: 7 to 10 Yrs Designation: Team Lead Location: Coimbatore Shift: EST Roles & Responsibilities Experience in End 2 End RCM is must. Should have minimum of 1 yrs experience as Team Lead. Team Handling, Work Allocation Report Management & Handling Client calls Preferred Immediate joiner's Interested pls share the resume in below watsapp number Number: 7397746206 Regards HR Team Qway Technologies
Posted 3 weeks ago
1.0 - 5.0 years
1 - 5 Lacs
Hyderabad, Chennai, Greater Noida
Work from Office
We Are Hiring || AR Caller || Payment Posting ||Reimbursement RCM || Pre - Auth || - Hyderabad, Chennai, Noida & Mumbai|| Pre auth openings in mumbai Eligibility Criteria :- Min 1+ yrs experience into AR Calling Package :- Up to 5lpa Location :- Hyderabad Work From Office 2 Way Cab Facility Notice Period :- Preferred Immediate Joiners Relieving is Mandate Immediate Joiner If Interested Kindly share your updated resume to nsweta.axis@gmail.com HR Swetha- 9059181703 References are Welcome
Posted 3 weeks ago
7.0 - 10.0 years
5 - 7 Lacs
Coimbatore
Work from Office
Dear Candidate's We are Hiring For AR Team Lead @ Coimbatore location Process: US Healthcare (RCM) Experience: 7 to 10 Yrs Designation: Team Lead Location: Coimbatore Shift: EST Roles & Responsibilities Experience in End 2 End RCM is must. Should have minimum of 1 yrs experience as Team Lead. Team Handling, Work Allocation Report Management & Handling Client calls Preferred Immediate joiner's Interested pls share the resume in below watsapp number Number: 7397746206 Regards HR Team Qway Technologies
Posted 3 weeks ago
10.0 - 14.0 years
9 - 13 Lacs
Navi Mumbai
Work from Office
Knowledge: • Excellent domain expertise and process knowledge about RCM for Hospital facility/Physician. • Understanding of Facility hospital verses Physician coding with indepth knowledge of the specialties - E&M-IP/OP. • Knowledge of EM – IP/OP, APC for optimizing the reimbursement and element of UHDDS and guidelines, Level of service determination with emphasis on Physical Examination & Medical Decision Making in Documentation guidelines, hospital E&M coding - initial/subsequent visit • Good knowledge of Human Anatomy, Physiology, Pathophysiology, Pharmacology, Diagnostic Studies, Conservative and Surgical Treatments. Understanding of Operative Reports and other report types with documentation requirements. • Aware of consequences of risky practices like up-coding and down-coding, Fraud and abuse, inflated documentation, HIPAA and CLIA rules mandating claim transmission. Responsibilities • Will be responsible for supervising and managing a team of 100+ QAs • Create an inspiring team environment with an open communication culture • Design QA capacity planning as per project requirement • Delegate tasks and set deadlines • Manage Quality of OP (ED/EM/SDS/ANC/OBV), ProFee Surgery & EM, and IP DRG projects • Quality control as per client SLA • Ensure effective implementation of organization’s Quality Management System • Monitor team performance and report on metrics • Performing random audit of auditor • Perform RCA on audits observations. Identify knowledge gaps and develop an action plan with quality leads and operation managers • Discover training needs and provide coaching to QAs • Listen to team members’ feedback and resolve any issues or conflicts • Recognize high performance and reward accomplishments • Encourage creativity and business improvement ideas • Suggest and organize team building activities • Identify improvement opportunities and initiate action plans for improvement
Posted 3 weeks ago
0.0 - 1.0 years
1 - 1 Lacs
Chennai
Work from Office
Greetings from Global Healthcare Billing Partners Pvt. Ltd.! We're looking for enthusiastic freshers with excellent communication skills to join our team as AR Callers. This is an exciting opportunity for graduates who are eager to start their career in the healthcare revenue cycle management industry. Key Responsibilities: Contact insurance companies to follow up on outstanding claims. Understand and analyze denials to resolve billing issues. Maintain accurate documentation of interactions and claim statuses. Requirements: Experience : Freshers are welcome Education : Any Graduate (Compulsory Degree completion required) Location: Candidates residing nearby Velachery or ready to relocate are preferred. Salary: 20000 CTC Work Mode : WFO Shift: Night Skills: Good Communication skills Basic understanding of healthcare or willingness to learn Good analytical and problem solving skills Ability to work in a fast paced environment Interview Mode: Direct Walk-in Date: 26-May-2025 & 28-May-2025 Timing: 1 PM to 6 PM **Kindly bring any one of your original Aadhar or Pan card with you**(Mandatory) Interested candidates can share your resume or contact this WhatsApp Number - 8925808592 Regards, Harini S HR Department
Posted 3 weeks ago
8.0 - 12.0 years
7 - 11 Lacs
Navi Mumbai
Work from Office
Excellent domain expertise and process knowledge about RCM for Hospital facility/Physician. • Understanding of Facility hospital verses Physician coding with indepth knowledge of the specialties - E&M-IP/OP. • Knowledge of EM – IP/OP, APC for optimizing the reimbursement and element of UHDDS and guidelines, Level of service determination with emphasis on Physical Examination & Medical Decision Making in Documentation guidelines, hospital E&M coding - initial/subsequent visit • Good knowledge of Human Anatomy, Physiology, Pathophysiology, Pharmacology, Diagnostic Studies, Conservative and Surgical Treatments. Understanding of Operative Reports and other report types with documentation requirements. • Aware of consequences of risky practices like up-coding and down-coding, Fraud and abuse, inflated documentation, HIPAA and CLIA rules mandating claim transmission. Responsibilities • Will be responsible for supervising and managing a team of 100+ QAs • Create an inspiring team environment with an open communication culture • Design QA capacity planning as per project requirement • Delegate tasks and set deadlines • Manage Quality of OP (ED/EM/SDS/ANC/OBV), ProFee Surgery & EM, and IP DRG projects • Quality control as per client SLA • Ensure effective implementation of organization’s Quality Management System • Monitor team performance and report on metrics • Performing random audit of auditor • Perform RCA on audits observations. Identify knowledge gaps and develop an action plan with quality leads and operation managers • Discover training needs and provide coaching to QAs • Listen to team members’ feedback and resolve any issues or conflicts • Recognize high performance and reward accomplishments • Encourage creativity and business improvement ideas • Suggest and organize team building activities • Identify improvement opportunities and initiate action plans for improvement
Posted 3 weeks ago
4.0 - 9.0 years
5 - 8 Lacs
Noida
Work from Office
Kozent Tec Pvt. Ltd (formerly known as Genesis Transcriptions Pvt. Ltd) is business associate of Panacea Solutions LLC having presence in US Healthcare documentation business for more than 20 years. We use cutting edge technology to help our US Healthcare Providers. We have diversified into Scribing, RCM and IT support services in the recent past and have aspiring growth plan. We have been operating from Noida. Role Quality Analyst/ Sr. Quality Analyst Responsibilities: Ensure adherence to companys policies and procedures. Act as an interface between the quality assurance executives and management. Ensure adherence to the client specific SLA’s. Ensure quality activities are in line with documented procedures and manage the day-to-day/routine operations. Have supervisorial responsibilities to delegate work and ensure that targets are achieved & reporting timelines are met. Monitoring performance by gathering relevant data and producing statistical reports. Conduct Monthly one-one session with the team to identify gap areas and initiate action plan accordingly. Conduct calibration sessions with the quality auditors and the operation team leaders to ensure they are in sync with the client / program expectations. Organize brainstorming sessions among the quality auditors and team leaders to find out the best possible way to tackle current issues / problems. Analyse data to identify areas for improvement in the quality system. Develop, recommend, and monitor corrective and preventive actions. Identifying relevant quality-related training needs and delivering training. (E.g., Feedback Delivery Method, Monitoring Methods, Data Analysis etc.) Strive for continual improvement of the existing quality monitoring systems and the processes by which they are developed. RELEVANT EXPERIENCE & EDUCATIONAL REQUIREMENTS Graduation and clearance of all major exams (SSC, HSC, qualifying degree). Knowledge or experience in healthcare. Six Sigma Certification will be an added advantage At least 1 year of experience as Quality Analyst in US Healthcare Min 5 years of experience working in an international BPO SILLS & COMPETENCIES Strong analytical, critical thinking and problem-solving skills. Excellent verbal and written communication skills. Excel proficiency. Strong organizational skills and adaptive capacity for rapidly changing priorities and workloads. Ability to work well independently and maintain focus on a topic for prolonged periods of time. Comfort in working with team members that are remote and located in the US or India. Job Type: Full-time Working days- 5 days week- Work from Office Shifts: US SHIFTS Location – NOIDA Sec- 3 Postion- 2 If you have relevant experience, feel free to share your profile at hr@panaceasolutionsllc.com or else call for telephonic interview 9266021789
Posted 3 weeks ago
0.0 - 5.0 years
1 - 6 Lacs
Ahmedabad
Work from Office
Job Title: Dental Accounts Receivable (AR) Executive Location: Makarba, Ahmedabad Department: Revenue Cycle Management / Dental Billing Employment Type: Full-Time (On-Site) Shift: Night Shift (U.S. Hours) Working Days: Monday to Friday (5 Days Working) Job Summary: We are hiring a Dental AR Executive to join our in-house night shift team in Makarba, Ahmedabad. This role is responsible for managing insurance claims, following up on pending accounts, and ensuring timely collections for U.S.-based dental practices. Key Responsibilities: Submit and track dental insurance claims efficiently and accurately. Follow up with U.S. insurance companies on unpaid or denied claims. Handle denial management and initiate appeals with proper documentation. Post payments received from insurance and patients into the billing software. Interact with patients regarding billing issues and outstanding balances. Prepare and analyze AR aging reports to track performance. Ensure all activities are documented accurately in the system. Maintain compliance with HIPAA and dental billing regulations. Coordinate with internal teams for claim escalations and resolutions. Requirements: 4 months to 10 years of experience in U.S. dental AR or healthcare revenue cycle management. Strong knowledge of dental coding (CDT), claims processing, and insurance procedures. Proficiency in dental billing software (e.g., Dentrix, Eaglesoft, Open Dental). Good English communication skills (written and verbal). Ability to work night shifts from the office. Benefits: Free meal facility provided by the company 5 days working (Saturday & Sunday off) Professional work environment with growth opportunities Competitive salary and performance-based incentives Note: This is a full-time, on-site position. Work from home is not available.
Posted 3 weeks ago
5.0 - 8.0 years
6 - 10 Lacs
Pune
Work from Office
Mandatory Skills: SAP SuccessFactor Employee Central. Experience5-8 Years.
Posted 3 weeks ago
5.0 - 10.0 years
19 - 20 Lacs
Gurugram
Work from Office
Hiring for Internal Auditor! Experience: 5 to 8 years Qualification: CA / ACCA / CPA / MBA / CA Inter / Graduate Industry: Manufacturing Skills: Internal Audit, RCM, Risk Advisory, Internal Controls. Entire Audit Lifecycle. Third Line of defense. Responsibilities End-to-end Business Process Walkthrough Identifying Risks & Developing Risk Control Matrix (RCM) Reviewing Process-Level Risk Assessments Testing Business Controls for Design & Operational Effectiveness Risk Reporting & Internal Controls Testing Preferred 2+ years of consulting experience
Posted 3 weeks ago
1.0 - 3.0 years
1 - 3 Lacs
Chennai
Work from Office
Role & responsibilities Primary Responsibilities: Review outstanding insurance balances to identify and resolve issues preventing finalization of claim payment; including coordinating with payers, patients and clients when appropriate Analyze and trend data, recommending solutions to improve first pass denial rates and reduce age of overall AR Accounts Receivable Specialist that has an "understanding" of the whole accounting cycle / claim life cycle Ensure all workflow items are completed within the set turn-around-time within quality expectations Able to analyze EOBs and denials at a claim level in addition they should find trends impacting dollar and #'s, leading to process improvements Perform other duties as assigned Comply with the terms and conditions of the employment contract, company policies and procedures, and any and all directives (such as, but not limited to, transfer and/or re-assignment to different work locations, change in teams and/or work shifts, policies in regards to flexibility of work benefits and/or work environment, alternative work arrangements, and other decisions that may arise due to the changing business environment). The Company may adopt, vary or rescind these policies and directives in its absolute discretion and without any limitation (implied or otherwise) on its ability to do so Preferred candidate profile Required Qualifications: Graduate 12+ months and above experience in healthcare accounts receivable required (Denial Management) - Hospital Billing is mandatory Solid knowledge of medical insurance (HMO, PPO, Medicare, Medicaid, Private Payers) In-depth working knowledge of the various applications associated with the workflows Knowledge / Skills / Abilities: Solid knowledge and use of the American English language skills with neutral accent Functional knowledge of HIPAA rules and regulations and experience related to privacy laws, access and release of information Proficient in MS Office software; particularly Excel and Outlook Proven ability to communicate effectively with all internal and external clients Proven ability to use good judgment and critical thinking skills; ability to identify and resolve problems Proven to be efficient and accurate keyboard/typing skills Proven solid work ethic and a high level of professionalism with a commitment to client/patient satisfaction If you are interested and match the required qualification then please reach out at below mail id- himanshi.kaul@optum.com
Posted 3 weeks ago
4.0 - 6.0 years
6 - 10 Lacs
Ahmedabad
Work from Office
Essential Functions: Monitors daily operations including work allocation, FTE utilization, meetings, updates, downtime management etc. Ensures an accurate, efficient, effective, and timely team approach to daily operations of the Medical Billing services so that billing will be of high quality. Proactively manages all queries in relation to billing/Payment Posting/AR and follow up with the providers wherever required. Undertakes audit activities to confirm quality assurance from both - billing /Payment Posting/AR guidelines and performance, adherence to /Payment Posting/AR processes perspective. Excellent communication with other RCM cross departments to ensure no gaps are present in the end-to-end RCM processes. Leads in quality improvement projects and actions as appropriate, i.e., error analysis and feedback to team members. Provides weekly and monthly report covering agreed KPIs, service improvements and any potential/real issues/risks. Evaluates individual performance, through goal setting and performance scorecards (1 on 1 meetings) Being a focal point for the team for communication and issue identification, resolution, and escalation, accordingly. Encourages and shares knowledge and skills with concerned departments, including the provision of technical mentoring and coaching of team members where appropriate. Responds to issues, queries and concerns of CSM/Managers/Cilents as needed and in a timely manner. Confidentiality is maintained and privacy respected. Leads and promotes a team environment that enhances partnership and cooperation through effective liaison, communication, and an inclusive approach. Actively participates in management meetings as required. Qualifications: - 3-5 Years Experience working as a medical office manager or medical billing manager required Workers Comp Billing Experience Required Experience with patient billing issues Experience with eClinicalWorks, AdvancedMD, Kareo, AthenaHealth, AllScripts preferred but not required Excellent customer service skills Excellent oral and written communication skills Contribute to a positive team atmosphere - This position does not require travel. Experience with one of the following PM Software required: Kareo, eClinicalWorks, AllScripts, Advanced MD, MD Synergy, GE Centricity, Dr.Chrono, NextGen, or Greenway
Posted 3 weeks ago
1.0 - 5.0 years
2 - 5 Lacs
Pune, Chennai, Bengaluru
Work from Office
Urgent Opening for AR Caller/SR AR Caller -Medical Billing-Voice Process Job Loc:Chennai, Trichy, Bangalore, Pune Exp:1yr-5yrs Salary:40k Max Skills:Any Billing ,Denials, Prior Auth NP:Imm IF INTERESTED CALL/WATSAPP:8610746422 REGARDS; Vijayalakshmi
Posted 3 weeks ago
5.0 - 7.0 years
5 - 12 Lacs
Bengaluru
Work from Office
Job Summary We are seeking a Process Specialist with 5 to 7 years of experience in HealthCare Products. The ideal candidate will have expertise in Prov Privileges excl Hospital Demo Changes Credentialing and Re-credentialing. This hybrid role requires working night shifts and does not involve travel. The candidate will play a crucial role in ensuring the efficiency and accuracy of healthcare processes. Responsibilities Lead the implementation of healthcare product processes to ensure compliance with industry standards. Oversee the management of provider privileges excluding hospital settings. Provide expertise in handling demographic changes within healthcare systems. Ensure accurate and timely credentialing and re-credentialing of healthcare providers. Collaborate with cross-functional teams to streamline healthcare operations. Monitor and evaluate process performance to identify areas for improvement. Develop and maintain documentation for healthcare processes and procedures. Train and mentor team members on best practices and process improvements. Conduct regular audits to ensure adherence to regulatory requirements. Utilize data analytics to drive decision-making and enhance process efficiency. Communicate effectively with stakeholders to address process-related issues. Implement process changes to improve patient care and operational efficiency. Support the development and execution of strategic initiatives in healthcare operations. Qualifications Possess a strong background in healthcare products and processes. Demonstrate expertise in provider privileges excluding hospital settings. Have experience in managing demographic changes within healthcare systems. Show proficiency in credentialing and re-credentialing of healthcare providers. Exhibit strong analytical and problem-solving skills. Display excellent communication and collaboration abilities. Certifications Required Certified Provider Credentialing Specialist (CPCS)
Posted 3 weeks ago
1.0 - 4.0 years
1 - 5 Lacs
Mumbai, Hyderabad, Chennai
Work from Office
We Are Hiring || AR Caller || Up to 40 K Take-home || HYD & CHENNAI & MUMBAI Eligibility Criteria :- Min 1+ yrs experience into AR Calling Package :- Up to 40k take home Location :- Hyderabad Work From Office 2 Way Cab Notice Period :- Preferred Immediate Joiners Relieving is not Mandate Immediate Joiner Interested candidates can share your updated resume to HR Sumalika - 9030461574 (share resume via WhatsApp ) Refer your friend's / Colleague
Posted 3 weeks ago
1.0 - 4.0 years
2 - 4 Lacs
Hyderabad
Work from Office
Key Responsibilities:- Follow up with payers to obtain claim status updates Prevent claim write-offs through timely follow-ups Work on billing scrubbers and make necessary edits Handle contractual adjustments and write-off projects Required Candidate profile notice period:- immediate joiners Mandate 1- 2 years of experience in denials Knowledge about codes -Modifier 59,24,25 Perks and benefits 2-way cab facility (Under 25-30km) One time meal
Posted 3 weeks ago
1.0 - 4.0 years
1 - 5 Lacs
Chennai, Coimbatore, India
Work from Office
Job Description: Outbound calls to insurances for claim status and eligibility verification. Denial documentation and further action. Calling the insurance carriers based on the appointment received by the clients. Working on the outstanding claims reports/account receivable reports received from the client or generated from the specific client software. Calling insurance companies to get the status of the unpaid claims. Willing to work in any process pertaining to voice based on the requirement (Insurance Follow UP, Patient calling, Provider outreach program etc. Maintain the individual daily logs. Performs assigned tasks/ completes targets with speed and accuracy as per client SLAs. Work cohesively in a team setting. Assist team members to achieve shared goals. Compliance with Medusinds Information Security Policy, client/project guidelines, business rules and training provided, companys quality system and policies. Communication / Issue escalation to seniors if there is any in a timely manner. Location: Chennai/Coimbatore Shift Time: 8pm to 5am / 5:30pm to 2:30am Experience: 1+ year of experience into AR Calling voice Educational Qualifications: Any Undergraduate or Graduate. Interested Candidates call me 8248361225 Muthuvel Hr
Posted 3 weeks ago
1.0 - 4.0 years
1 - 5 Lacs
Ahmedabad, Chennai, Coimbatore
Work from Office
Job Description: Outbound calls to insurances for claim status and eligibility verification. Denial documentation and further action. Calling the insurance carriers based on the appointment received by the clients. Working on the outstanding claims reports/account receivable reports received from the client or generated from the specific client software. Calling insurance companies to get the status of the unpaid claims. Willing to work in any process pertaining to voice based on the requirement (Insurance Follow UP, Patient calling, Provider outreach program etc. Maintain the individual daily logs. Performs assigned tasks/ completes targets with speed and accuracy as per client SLAs. Work cohesively in a team setting. Assist team members to achieve shared goals. Compliance with Medusinds Information Security Policy, client/project guidelines, business rules and training provided, companys quality system and policies. Communication / Issue escalation to seniors if there is any in a timely manner. Location: Chennai/Coimbatore Shift Time: 8pm to 5am / 5:30pm to 2:30am Experience: 1+ year of experience into AR Calling voice Educational Qualifications: Any Undergraduate or Graduate. Interested Candidates call me 8248361225 Muthuvel Hr
Posted 3 weeks ago
4.0 - 7.0 years
4 - 4 Lacs
Karnal
Work from Office
Hiring for Accountant Location - Karnal Salary - Up To 4.5lpa Experience - 4 to 6 Years Must have a good knowledge of GST , TDS, Income tax Returns , TCS , RCM
Posted 3 weeks ago
3.0 - 5.0 years
4 - 5 Lacs
Pune
Work from Office
Role & responsibilities Manage daily accounting operations and bank transactions. Monitor bank positions and perform bank reconciliations Record purchase entries and process vendor payments Prepare working files for GST, TDS, and apply for GST refunds Ensure timely filing of GST returns, TDS returns, and other statutory filings Handle FEMA and EBRC compliance, including online submissions and closure of shipping bills Support in Script Sales transactions and related compliance Coordinate and comply with Audit requirements, including GST and statutory audits Manage and process admin-related bills and ensure accurate entries Prepare and share MIS reports with the Deputy Manager and global finance teams Assist in maintaining compliance for Income Tax, RCM, and Input Credit working Support closure activities related to shipping and export documentation Preferred candidate profile Bachelors degree in Commerce, Finance, or a related field (MBA or CA Inter preferred) 35 years of relevant experience in core accounting and compliance roles Strong knowledge of GST, TDS, FEMA, Income Tax, and Audit processes Hands-on experience with banking transactions, foreign transactions, and vendor payments Proficiency in accounting software and MS Excel Attention to detail, ability to multitask, and strong organizational skills Good communication skills and ability to coordinate with cross-functional teams
Posted 3 weeks ago
10.0 - 12.0 years
9 - 14 Lacs
Bengaluru
Work from Office
About the Job: We are looking for a passionate and dynamic experienced Finance Professional to join our team at Manipal Hospitals! About Us: As a pioneer in Healthcare, Manipal Hospitals is among the top healthcare providers in India serving over 5 million patients annually. Today we stand as an integrated network with a pan-India footprint of 37 hospitals across 19 cities with 10,500 beds, and a talented pool of over 5,600 doctors and an employee strength of over 20,000. Role: Internal Audit Location: Bangalore What You’ll Do: Assess and prepare periodic / specific audit reports /MIS as desired by the management and communicate results of audit to stakeholders. Ensure RCM are tested with adequate samples to determine efficiency and effectiveness of internal systems and processes. Examine and evaluate financial and information systems, recommending controls to ensure system reliability and data integrity. Examine records and interview respective employees to ensure a proper system for recording of transactions and compliance with laws and regulations. Visit units & HO function as per Annual Audit plan, inspect books, records and systems, perform or supervise audit as planned. Analyze data to detect deficient controls, duplicated efforts, extravagance, fraud, or non-compliance with laws, regulations, and management policies. Use the audit findings for rectifications and improvements. Follow up to determine adequacy of corrective action and implementation of same Meeting with Senior Management and Audit committee to decide on the focus point of audit, to study previous audit reports and to prepare annual audit budget / plan based on such studies. Review the means of safeguarding assets and verify the existence of such assets Review asset utilization and audit results and recommend changes in operations and financial activities. What We Are Looking For: Chartered Accountant 10-12 years of experience What We Offer: Competitive salary and benefits package Opportunities for professional development and career growth A collaborative and inclusive work environment Roles and Responsibilities Support the Internal Audit Head to: Examine and evaluate financial and information systems, recommending controls to ensure system reliability and data integrity. Examine records and interview respective employees to ensure a proper system for recording of transactions and compliance with laws and regulations. Visit units & HO function as per Annual Audit plan, inspect books, records and systems, perform or supervise audit as planned. Analyze data to detect deficient controls, duplicated efforts, extravagance, fraud, or non-compliance with laws, regulations, and management policies. Assess and prepare periodic / specific audit reports /MIS as desired by the management and communicate results of audit to stakeholders. Meeting with to Senior Management and Audit committee to decide on the focus point of audit, to study previous audit reports and to prepare annual audit budget / plan based on such studies. Use the audit findings for rectifications and improvements. Follow up to determine adequacy of corrective action and implementation of same Review the means of safeguarding assets and verify the existence of such assets Review asset utilization and audit results and recommend changes in operations and financial activities. Ensure RCM are tested with adequate samples to determine efficiency and effectiveness of internal systems and processes. Support and test the key control automation process Provide guidance and direction to relevant team members as required. Ensure good corporate governance and ethics in the organization.
Posted 3 weeks ago
0.0 years
0 Lacs
Hyderabad
Work from Office
MEDICAL CODER / MEDICAL BILLER Job Description We are looking for a detail-oriented and proactive Eligibility Executive to manage insurance verification and benefits validation for patients in the revenue cycle process. The ideal candidate will have experience working with U.S. healthcare insurance systems, payer portals, and EHR platforms to ensure accurate eligibility checks and timely updates for claims processing. Key Responsibilities Verify patient insurance coverage and benefits through payer portals, IVR, or direct calls to insurance companies. Update and confirm insurance details in the practice management system or EHR platforms accurately and in a timely manner. Identify policy limitations, deductibles, co-pays, and co-insurance information and document clearly for billing teams. Coordinate with patients and internal teams (billing, front desk, scheduling) to clarify eligibility-related concerns. Perform eligibility checks for scheduled appointments, procedures, and recurring services. Handle real-time and batch eligibility verifications for various insurance types including commercial, Medicaid, Medicare, and TPA. Escalate discrepancies or inactive coverage to the concerned team and assist in resolving issues before claim submission. Maintain up-to-date knowledge of payer guidelines and insurance plan policies. Ensure strict adherence to HIPAA guidelines and maintain confidentiality of patient data. Meet assigned productivity and accuracy targets while following internal SOPs and compliance standards. Preferred Skills & Tools Experience with EHR/PM systems like eCW, NextGen, Athena, CMD Familiarity with major U.S. insurance carriers and payer portals Strong verbal and written communication skills Basic knowledge of medical billing and coding is a plus Ability to work in a fast-paced, detail-focused environment Qualifications ANY LIFE SCIENCE DEGREE BSc, MSc, B.Pharm, M.Pharm, BPT NOTE CPC certification preferable
Posted 3 weeks ago
2.0 - 3.0 years
4 - 5 Lacs
Pune, Maharashtra, India
On-site
Job description Excellent Knowledge in Denials Can perform HIPAA compliant auto and manual posting requirements Executes daily payment posting batch reconciliation Understanding of posting offsets, forward balance, and refund processing / posting Familiar with denial and remarks codes to perform posting and assignment of AR appropriately Familiar with secondary billing process while perform cash posting Clear understanding on: ERA & EOB Insurance types Balance billing Co-ordination of Benefits Ensure full compliance with all company, departmental, legal and regulatoryrequirements with regards to Payment Posting procedures and practices Good verbal and written communication and presentation skills Ability to execute and accomplish tasks consistently within deadlines Basic knowledge of MS Office Experience working on imagine systems and Advanced MD would be an added advantage Role: Healthcare & Life Sciences - Other Industry Type: BPO / Call Centre Department: Healthcare & Life Sciences Employment Type: Full Time, Permanent Role Category: Healthcare & Life Sciences - Other Education UG: Graduation Not Required
Posted 3 weeks ago
1.0 - 5.0 years
2 - 5 Lacs
Bengaluru
Work from Office
Dear Applicant, Excellent opportunity ! Position / Title : AR Caller / Senior AR Caller Responsibility Areas 1. Should handle US Healthcare providers/ Physicians/ Accounts Receivable. 2. To work closely with the team leader. 3. Ensure that the deliverables to the client adhere to the quality standards. 4. Responsible for working on Denials, Appeals,Rejections, LOA's to accounts etc. 5. To review emails for any updates 7. Identify issues and escalate the same to the immediate supervisor 8. Update Production logs 9. Strict adherence to the company policies and procedures. Desired Profile 1. Sound knowledge in Healthcare concept (Physician Billing). 2. Should have Minimum 1 Year of AR calling Experience . 3. Excellent Knowledge on "RCM, Medicare, Medicade, Hospice, HMO,PPO,POS,EPO,MCO plans, Modifiers, Office code visit, CPT codes, Drug codes, Appeals, Denial management, CMS-1500 form, clearing house" etc . 4. Understand the client requirements and specifications of the project 5. Should be proficient in calling the insurance companies. 6. Ensure targeted collections are met on a daily / monthly basis 7. Meet the productivity targets of clients within the stipulated time. 8. Ensure accurate and timely follow up on pending claims wherein required. 9. Prepare and Maintain status reports. Interested candidate please share your resume below mail id or share the resume on Whatsapp. Contact HR : Mohammed Zaid Mail Id : Mohammed.Zaid@omegahms.com or Whatsapp me @ 8971604307 Regards, Team HR
Posted 3 weeks ago
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Revenue Cycle Management (RCM) is a crucial aspect of the healthcare industry in India, ensuring that healthcare providers receive proper reimbursement for services rendered. The demand for RCM professionals in India is on the rise, with many opportunities available for job seekers in this field.
The average salary range for RCM professionals in India varies based on experience and location. Entry-level positions typically start at around ₹2-4 lakhs per annum, while experienced professionals can earn upwards of ₹8-12 lakhs per annum.
In the RCM field, a typical career path may progress as follows: - RCM Analyst - RCM Team Lead - RCM Manager - RCM Director
In addition to expertise in RCM, professionals in this field are often expected to have skills in: - Medical coding - Healthcare billing systems - Data analysis - Communication skills
As you explore opportunities in the RCM job market in India, remember to showcase your skills and experience confidently during interviews. Prepare thoroughly and demonstrate your knowledge of the field to stand out as a top candidate. Best of luck in your job search!
Browse through a variety of job opportunities tailored to your skills and preferences. Filter by location, experience, salary, and more to find your perfect fit.
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